基于血流动力学分析和计算流体动力学的川崎病冠状动脉瘤风险分层研究

Jongmin Seo
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摘要

本文综述了应用计算流体力学(CFD)模拟方法评估川崎病(KD)致冠状动脉动脉瘤(CAA)风险的研究进展。患者特异性CFD是一种新兴工具,可提供详细的三维血流动力学信息,这是目前标准成像技术或侵入性测量所无法提供的。本文综述了KD - CAA的CFD研究,使用计算机断层扫描(CT)或磁共振成像(MRI)图像重建由主动脉和冠状动脉组成的三维解剖几何。在解剖模型的入口和出口,规定了生理边界条件,以匹配所测量的患者特异性血压或流量数据,并辅以群体研究的生理规则。然后根据模拟结果量化血流动力学变量,如血流速度、壁面剪切应力、振荡剪切指数、分数血流储备和颗粒停留时间。这些研究表明,这些血流动力学参数与临床结果之间存在很强的相关性,表明血流动力学指标可用于KD患者的治疗计划。我们讨论了所回顾研究的局限性,包括样本量小,对血栓形成的狭窄关注,以及使用不同的成像方式。本文提出了解决这些局限性的KD CFD研究的未来研究方向。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Advancing Risk Stratification of Coronary Artery Aneurysms Caused by Kawasaki Disease Using Hemodynamics Analysis and Computational Fluid Dynamics
This article reviews previous studies on the risk assessment of coronary artery aneurysms (CAA) caused by Kawasaki disease (KD) using the computational fluid dynamics (CFD) simulation. Patient-specific CFD is an emerging tool that provides detailed three-dimensional hemodynamic information, not available from current standard imaging techniques or invasive measures. The reviewed CFD studies on KD CAA used Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) images to reconstruct the three-dimensional anatomical geometry consisting of the aorta and coronary arteries. On the inlet and outlet of the anatomical model, physiologic boundary conditions were prescribed to match the measured patient-specific blood pressure or flow data, supplemented by physiologic rules informed by population studies. Hemodynamic variables such as the blood velocity, wall shear stress, oscillatory shear index, fractional flow reserve, and particle residence time, were then quantified from the simulation results. The studies reviewed revealed strong correlations between these hemodynamic parameters and clinical outcomes, suggesting that hemodynamic metrics could be useful for treatment planning for KD patients. We discuss the limitations of the reviewed studies including small sample sizes, a narrow focus on thrombosis, and the use of different imaging modalities. The article suggests future research directions for CFD studies of KD that address these limitations.
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