上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (7): 961-.doi: 10.3969/j.issn.1674-8115.2012.07.030

• 技术与方法 • 上一篇    

颈动脉支架植入术治疗颈动脉狭窄效果的数值模拟

邱晓宁1, 费智敏2, 施圣贤1, 张 珏3, 曹兆敏1   

  1. 1.上海交通大学 动力机械与工程叶轮机械教育部重点实验室, 上海 200240； 2.上海中医药大学附属曙光医院神经外科, 上海 203204； 3.上海交通大学 医学院附属仁济医院神经外科, 上海 200127
  • 出版日期:2012-07-28 发布日期:2012-08-17
  • 通讯作者: 费智敏, 电子信箱: tommyfei@126.com。
  • 作者简介:邱晓宁（1982—）, 男, 博士生；电子信箱: xiaoning0018@126.com。
  • 基金资助:

    中华医学会临床医学科研专项基金（09010200175）；国家自然科学基金（50906049）

Numerical simulation of therapeutic effect of carotid artery stenting on carotid artery stenosis

QIU Xiao-ning1, FEI Zhi-min2, SHI Sheng-xian1, ZHANG Jue3, CAO Zhao-min1   

  1. 1.Key Laboratory of the Education Ministry of China for Power Machinery and Engineering, Shanghai Jiaotong University, Shanghai 200240, China； 2.Department of Neurosurgery, Shuguang Hospital|Shanghai University of Traditional Chinese Medicine, Shanghai 203204, China； 3.Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2012-07-28 Published:2012-08-17
  • Supported by:

    Chinese Medical Association Foundation, 09010200175；National Natural Science Foundation of China, 50906049

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摘要：

目的 采用计算流体力学数值模拟方法对颈动脉支架植入术（CAS）治疗颈动脉狭窄的效果进行评估。方法 采用Mimics软件对1例颈动脉狭窄患者手术前后的CT影像进行三维重建，构建个体化颈动脉分叉模型，利用计算流体力学方法对模型进行三维流动数值模拟计算，以壁面剪切应力、壁面压力、血流轨迹和流量等血流动力学指标对CAS的疗效进行评估。结果 数值模拟计算结果显示：与术前比较，CAS术后颈动脉内的流动速度、颈内与颈外动脉的流量分配比例、壁面剪切力和壁面压力等血流动力学指标发生明显变化，血液流动状态明显改善。结论 计算流体力学数值模拟评估CAS的效果更为直观且合理，并能够在术前为个体病例提供最优的指导性方案。

关键词: 颈动脉支架植入术, 颈动脉狭窄, 血流动力学, 计算流体力学, 数值模拟

Abstract:

Objective To evaluate the therapeutic effect of carotid artery stenting (CAS) on carotid artery stenosis with computational fluid dynamics. Methods Three-dimensional reconstruction of CT images before and after operation was conducted with Mimics software in one patient with carotid artery stenosis. Individualized carotid artery bifurcation model was constructed, and computational fluid dynamics was employed to perform three-dimensional fluid numerical simulation calculation. The therapeutic effect of CAS was evaluated with hemodynamic parameters of wall shear stress, wall pressure, blood flow tract and blood volume. Results Numerical simulation calculation indicated that compared with those before operation, there were significant changes in carotid blood flow velocity, blood flow distribution between internal carotid artery and external carotid artery, wall shear stress and wall pressure, and the blood flow state was significantly improved. Conclusion Computational fluid dynamics numerical simulation is rational in evaluation of therapeutic effect of CAS, and can provide individualized optimal guidance before operation.

Key words: carotid artery stenting, carotid artery stenosis, hemodynamics, computational fluid dynamics, numerical simulation