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颈内动脉扭曲的血流动力学数值模拟和临床研究

Clinical study and numerical simulation of hemodynamics in the tortuosity of internal carotid artery

摘要:

目的 建立颈内动脉扭曲的血流动力学理论分析模型,研究扭曲动脉导致的血流动力学变化规律,初步探讨动脉扭曲和脑缺血的关系.方法 以颈内动脉的生理解剖参数为原型,建立动脉扭曲的几何模型,根据血液流动的边界条件,对扭曲动脉的血液流动进行有限元数值模拟.对颈内动脉扭曲患者和对照组患者各15例进行临床实测,用微导管和压力传感器测量颈内动脉扭曲前后的压力,用血管造影机计算扭曲动脉的直径和长度.结果 数值模拟结果显示随着动脉扭曲程度的加重,血流的压降增大,伸长长度增加;临床实测结果显示出相同的变化趋势.结论 颈内动脉扭曲可以造成动脉扭曲远端血压下降,在一定情况下,严重的动脉扭曲可能是脑缺血发作相关因素之一.

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abstracts:

Objectives To establish a theoretical model for the tortuosity of internal carotid artery and summarize the hemodynamic rulc of blood flow in a tortuous artery. To explore the relationship of cerebral ischemia and tortuous internal carotid artery. Methods Taking the internal carotid artery as a prototype, a geometric model of a tortuous artery was constructed according to the normal physiological and anatomical parameters of internal carotid artery. The boundary conditions and calculation conditions of blood flow are proposed. The numerical simulation of the blood flow in the tortuous artery is carried out with finite element method. Hemodynamic parameters of internal carotid artery were measured in 15 cases with the tortuosity of internal carotid artery and in 15 cases of normal control group. Blood pressure was measured by microcatheter connecting a pressure transducer at internal carotid artery, pre-tortuous and post-tortuous artery. The diameter and length of the above artery were measured and calculated by DSA machine. Results Numerical simulation results indicated pressure drop of blood flow and elongated length of artery is increased with diminution of the angle of tortuous artery. Clinical measurement datas disclosed the same trend in the same curve as numerical simulation. Conclusion The elongation and tortuosity of internal carotid artery results in decrease of blood pressure in the distal segment of tortuous internal carotid artery, kinking of internal carotid artery may be one of factors related to attack of cerebral ischemia on certain conditions.

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作者: 王利军 [1] 王大明 [1] 赵峰 [2] 刘加春 [1] 陆军 [1] 祈鹏 [1] 朱辉 [1] 翟乐乐 [1] 姜学丽 [1]
第一作者: 王利军
期刊: 《中华外科杂志》2008年46卷21期 1658-1661页 MEDLINEISTICPKUCSCD
分类号: R6
栏目名称: 论著
DOI: 10.3321/j.issn:0529-5815.2008.21.017
发布时间: 2009-01-12
基金项目:
国家自然科学基金
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