Multi-modality image-based computational analysis of haemodynamics in aortic dissection

被引:104
作者
Dillon-Murphy, Desmond [1 ]
Noorani, Alia [1 ]
Nordsletten, David [1 ]
Figueroa, C. Alberto [1 ,2 ,3 ]
机构
[1] Kings Coll London, Dept Biomed Engn, London SE1 7EH, England
[2] Univ Michigan, Dept Surg, North Campus Res Complex B20-211W, Ann Arbor, MI 48109 USA
[3] Univ Michigan, Dept Biomed Engn, North Campus Res Complex B20-211W, Ann Arbor, MI 48109 USA
基金
欧洲研究理事会;
关键词
CFD; Aortic dissection; Multi-scale modelling; Cardiac work load; Intimal tears; NAVIER-STOKES EQUATIONS; FINITE-ELEMENT-METHOD; FLUID-DYNAMICS; COMPUTED-TOMOGRAPHY; BLOOD-FLOW; BOUNDARY-CONDITIONS; FALSE LUMEN; SPIRAL CT; TEAR SIZE; IN-VITRO;
D O I
10.1007/s10237-015-0729-2
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Aortic dissection is a disease whereby an injury in the wall of the aorta leads to the creation of a true lumen and a false lumen separated by an intimal flap which may contain multiple communicating tears between the lumina. It has a high associated morbidity and mortality, but at present, the timing of surgical intervention for stable type B dissections remains an area of debate. Detailed knowledge of haemodynamics may yield greater insight into the long-term outcomes for dissection patients by providing a greater understanding of pressures, wall shear stress and velocities in and around the dissection. In this paper, we aim to gather further insight into the complex haemodynamics in aortic dissection using medical imaging and computational fluid dynamics modelling. Towards this end, several computer models of the aorta of a patient presenting with an acute Stanford type B dissection were created whereby morphometric parameters related to the dissection septum were altered, such as removal of the septum, and the variation of the number of connecting tears between the lumina. Patient-specific flow data acquired using 2D PC-MRI in the ascending aorta were used to set the inflow boundary condition. Coupled zero-dimensional (Windkessel) models representing the distal vasculature were used to define the outlet boundary conditions and tuned to match 2D PC-MRI flow data acquired in the descending aorta. Haemodynamics in the dissected aorta were compared to those in an equivalent 'healthy aorta', created by virtually removing the intimal flap (septum). Local regions of increased velocity, pressure, wall shear stress and alterations in flow distribution were noted, particularly in the narrow true lumen and around the primary entry tear. The computed flow patterns compared favourably with those obtained using 4D PC-MRI. A lumped-parameter heart model was subsequently used to show that in this case there was an estimated 14 % increase in left ventricular stroke work with the onset of dissection. Finally, the effect of secondary connecting tears (i.e. those excluding the primary entry and exit tears) was also studied, revealing significant haemodynamic changes when no secondary tears are included in the model, particularly in the true lumen where increases in flow over and drops in peak pressure of 18 % were observed.
引用
收藏
页码:857 / 876
页数:20
相关论文
共 73 条
[1]   Modelling the circle of Willis to assess the effects of anatomical variations and occlusions on cerebral flows [J].
Alastruey, J. ;
Parker, K. H. ;
Peiro, J. ;
Byrd, S. M. ;
Sherwin, S. J. .
JOURNAL OF BIOMECHANICS, 2007, 40 (08) :1794-1805
[2]   Development of a patient-specific simulation tool to analyse aortic dissections: Assessment of mixed patient-specific flow and pressure boundary conditions [J].
Alimohammadi, Mona ;
Agu, Obiekezie ;
Balabani, Stavroula ;
Diaz-Zuccarini, Vanessa .
MEDICAL ENGINEERING & PHYSICS, 2014, 36 (03) :275-284
[3]  
Baaijens FPT, 2001, INT J NUMER METH FL, V35, P743, DOI 10.1002/1097-0363(20010415)35:7<743::AID-FLD109>3.0.CO
[4]  
2-A
[5]   Experimental and Clinical Evidence Supporting Septectomy in the Primary Treatment of Acute Type B Thoracic Aortic Dissection [J].
Berguer, Ramon ;
Parodi, Juan C. ;
Schlicht, Marty ;
Khanafer, Khalil .
ANNALS OF VASCULAR SURGERY, 2015, 29 (02) :167-173
[6]   Concomitant gradient terms in phase contrast MR: Analysis and correction [J].
Bernstein, MA ;
Zhou, XHJ ;
Polzin, JA ;
King, KF ;
Ganin, A ;
Pelc, NJ ;
Glover, GH .
MAGNETIC RESONANCE IN MEDICINE, 1998, 39 (02) :300-308
[7]   A longitudinal study of Type-B aortic dissection and endovascular repair scenarios: Computational analyses [J].
Chen, Duanduan ;
Mueller-Eschner, Matthias ;
Kotelis, Drosos ;
Boeckler, Dittmar ;
Ventikos, Yiannis ;
von Tengg-Kobligk, Hendrik .
MEDICAL ENGINEERING & PHYSICS, 2013, 35 (09) :1321-1330
[8]   Analysis of Flow Patterns in a Patient-Specific Aortic Dissection Model [J].
Cheng, Z. ;
Tan, F. P. P. ;
Riga, C. V. ;
Bicknell, C. D. ;
Hamady, M. S. ;
Gibbs, R. G. J. ;
Wood, N. B. ;
Xu, X. Y. .
JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME, 2010, 132 (05)
[9]  
CIBC, 2015, SEG3D VOL IM SEGM VI
[10]   A new imaging method for assessment of aortic dissection using four-dimensional phase contrast magnetic resonance imaging [J].
Clough, Rachel E. ;
Waltham, Matthew ;
Giese, Daniel ;
Taylor, Peter R. ;
Schaeffter, Tobias .
JOURNAL OF VASCULAR SURGERY, 2012, 55 (04) :914-923