单纯密网孔支架治疗兔动脉瘤的血流动力学数值模拟研究
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摘要
第一部分：兔特异性动脉瘤数值模型的建立及血流动力学分析
目的：基于兔动脉瘤模型的三维旋转造影资料,建立兔特异性动脉瘤数值模型,应用计算流体力学的方法分析动脉瘤模型的血流动力学特征。
方法：通过外科手术结合弹性酶建立兔动脉瘤模型,获取16例动脉瘤模型的三维旋转造影资料,初步剪切、加工后,经3DMAX软件转换、定标,再通过GEOMAGIC进一步切割、截取和光滑处理,所得结果在ANSYS CFD中建立有限元网格,即数值模型。在一定的假设前提下,有限元网格在ANSYS CFX配置边界条件后并进行计算,得出动脉瘤模型的壁面切应力、流线、速度场、压力场等多种结果,并对这些动脉瘤血流动力学特征与病人特异性颅内动脉瘤的血流动力学特征进行分析比较。
结果：兔动脉瘤高壁面切应力位于流入道、动脉瘤内流场复杂多样、冲击域位于流入道,压力场分布均匀,与病人特异性动脉瘤的血流动力学特征相吻合。结论：通过外科手术结合弹性酶建立兔动脉瘤模型的血流动力学特征很好的模拟了病人特异性颅内动脉瘤血流动力学特征,可以用于不同治疗方法的实验研究。
第二部分：单纯密网孔支架植入对动脉瘤内血流动力学影响的数值模拟研究
目的：通过数值模拟的方法,研究单纯密网孔支架植入后对动脉瘤内血流动力学特征的影响。
方法：共获得14例兔特异性动脉瘤模型的三维旋转造影资料及所植入支架的MICRO-CT扫描的影像资料。用兔动脉瘤模型的3DRA资料建立动脉瘤血管模型。用MIMICS10.01建立支架模型。再通过GEOMAGIC进一步将支架的覆盖瘤颈的区域截取,采用布尔运算的方法将支架释放到动脉瘤模型中。所得结果在ANSYS CFD中建立有限元网格,即数值模型。在一定的假设前提下,对支架植入前后的有限元网格分别在ANSYS CFX相同的配置边界条件后并进行计算,得出支架植入前后的动脉瘤模型的壁面切应力、流线、速度场、压力场等的结果,并对支架植入前后的动脉瘤血流动力学特征与进行分析比较并得出统计学结果。
结果：支架植入后动脉瘤的壁面切应力明显降低,动脉瘤内的复杂流场变成简单流场,动脉瘤壁的压力场无明显变化。支架术前后动脉瘤远侧壁、动脉瘤顶的壁面切应力有统计学差异(P=0.003,P=0.001)；支架术前后动脉瘤近侧壁的壁面切应力无统计学差异(P=0.13)；支架术前后动脉瘤远侧壁、动脉瘤顶、动脉瘤近侧壁的压力的无统计学差异(P>0.01)。
结论：支架植入术后可改变动脉瘤的壁面切应力和动脉瘤内流场等血流动力学参数,可能对动脉瘤的愈合创造有利条件。
第三部分：支架植入对动脉瘤内血流动力学影响的数值模拟研究与动物实验对比研究
目的：通过支架植入术后血流动力学数值模拟研究结果与实验研究结果的比较探索支架植入后的血流动力学变化与动脉瘤愈合的关系。
方法：将动脉瘤模型根据复查造影是否显影分为两组：愈合组10例,未愈合组4例。对两组的支架术前后的壁面切应力和压力等血流动力学变化进行比较并得出统计学结果。
结果：愈合组和未愈合组的支架术前后的壁面切应力和压力等血流动力学的变化有明显差别,但是无统计学差异(P>0.01)。
结论：本研究表明数值模拟研究中发现的支架术后壁面切应力的变化与动脉瘤的愈合相关,需更更大样本的数值模拟研究模型进一步对血流动力学的变化及其与临床结果的相关性进行研究。
Part one:Establishment of rabbit-specific numerical intracranial aneurysm model and analysis of hemodynamics
Objective:To establish a numerical model of rabbit-specific aneurysm model based on 3D rotation angiography image and analyze the hemodynamic characters of the aneurysms.
Methods:we established histologically simulating human aneurysms by using elastase to digest the right common carotid artery.The 3DRA images of 16 rabbit-specific aneurysm models were transferred into 3 DM AX then GEOMAGIC for being segmented and smoothed surface data. The surface data was imported into ANSYS CFD in order to create finite element grids. After meshing, we applied ANSYS CFX to create configuration files for fluid field computations and structural mechanics computations respectively, which include the setting of material properties, boundary condition and time step. At last we obtained the hemodynamic parameters including wall shear stress, streamline, velocity profile and pressure profile.
Results:We analyzed hemodynamic characters of rabbit-specific aneurysm models including WSS distribution, maximum WSS, streamline, intra-aneurysmal flow pattern, velocity profile, velocity and width of inflow jet, location and size of impaction zone.
Conclusion:The hemodynamic characters of rabbit-specific aneurysm model are well consistent with that of the human intracranial aneurysm.
Part two:Study of hemodynamic changes induced by virtual placement of the high porocity stent across rabbit-specific aneurysm
Objective:The goal was to study the effects of the high porocity stent on aneurysm hemodynamics using computational fluid dynamics.
Methods:We obtained the DRA images of 14 rabbit-specific aneurysm models and the Micro-computed tomographic angiography images of the stent samples extracted from rabbits treated by solo stent.computed tomographic angiography images. The geometries of rabbit-specific aneurysm models were reconstructed from the DRA images. The geometry of high porocitystents were reconstructed from the computed tomographic angiography images.To deploy the stent in the aneurysm models, the part geometries of the stents were virtually deformed to fit into the parent vessel lumen across the aneurysm neck. The separately reconstructed aneurysm and stent geometries were merged in a single model in ICEM-CFD and meshed. After meshing, we applied ANSYS CFX to create configuration files for fluid field computations and structural mechanics computations respectively, which include the setting of material properties, boundary condition and time step. At last we obtained the hemodynamic parameters including wall shear stress, streamline, velocity profile and pressure profile of both the stented and the unstented aneurysms Some comparisons of the hemodynamic characters of the stented aneurysms with that of the unstented aneurysms including WSS, streamline, intra-aneurysmal flow pattern, velocity profile, velocity and width of inflow jet, location and size of impaction zone were also made
Results:the elevated WSS area was more significantly reduced by stenting,The complex flow pattern observed in the unstented aneurysm was suppressed by stenting.but the pressure on the inner wall of the pressure of the aneurysm was not suppressed by stenting. Stent placement lowered the wall shear stress in the aneurysm, In the stented and unstented aneurysms paring research, there was significant statistic difference in the WSS magnitude on the dome and the distal pouch of the aneurysm between the stented aneurysms group and the unstented aneurysms group (P<0.01),but there was no significant statistic difference in the WSS on the proximal wall near the neck(P=0.13).There was also no significant statistic difference in the pressure on the dome and that on the inner wall of the aneurysm near the proximal and distal pouch of the aneurysm(P>0.01).
Conclusion:Aneurysm hemodynamic parameters were significantly modified by placement of low porocity stents.
Part three:Comparison of the results of numerical and experimental studies in the stented rabbit-specific aneurysm model
Objective:To investigate the different hemodynamic characters in the healed and the unhealed aneurysms and characterize possible associations with the occlusion of the aneurysms.
Methods:We devided the 14 rabbit-specific aneurysm models intotwo groups:the healed group (n=10) and the unhealed group (n=4), according to the follow-up angiography. Some comparisons of the hemodynamic characters of the healed aneurysms with that of the unhealed aneurysms including WSS, pressure were made.
Results:In the paring research, There was significant difference between the two groups,although there was no significant statistic difference in the WSS magnitude on the dome and the distal pouch of the aneurysm between the heaed aneurysms group and the unhealed aneurysms group (P>0.01).
Conclusion:The computed results are verified by experimental studies.further investigation are needed in this area in larger series.
目的：基于兔动脉瘤模型的三维旋转造影资料,建立兔特异性动脉瘤数值模型,应用计算流体力学的方法分析动脉瘤模型的血流动力学特征。
方法：通过外科手术结合弹性酶建立兔动脉瘤模型,获取16例动脉瘤模型的三维旋转造影资料,初步剪切、加工后,经3DMAX软件转换、定标,再通过GEOMAGIC进一步切割、截取和光滑处理,所得结果在ANSYS CFD中建立有限元网格,即数值模型。在一定的假设前提下,有限元网格在ANSYS CFX配置边界条件后并进行计算,得出动脉瘤模型的壁面切应力、流线、速度场、压力场等多种结果,并对这些动脉瘤血流动力学特征与病人特异性颅内动脉瘤的血流动力学特征进行分析比较。
结果：兔动脉瘤高壁面切应力位于流入道、动脉瘤内流场复杂多样、冲击域位于流入道,压力场分布均匀,与病人特异性动脉瘤的血流动力学特征相吻合。结论：通过外科手术结合弹性酶建立兔动脉瘤模型的血流动力学特征很好的模拟了病人特异性颅内动脉瘤血流动力学特征,可以用于不同治疗方法的实验研究。
第二部分：单纯密网孔支架植入对动脉瘤内血流动力学影响的数值模拟研究
目的：通过数值模拟的方法,研究单纯密网孔支架植入后对动脉瘤内血流动力学特征的影响。
方法：共获得14例兔特异性动脉瘤模型的三维旋转造影资料及所植入支架的MICRO-CT扫描的影像资料。用兔动脉瘤模型的3DRA资料建立动脉瘤血管模型。用MIMICS10.01建立支架模型。再通过GEOMAGIC进一步将支架的覆盖瘤颈的区域截取,采用布尔运算的方法将支架释放到动脉瘤模型中。所得结果在ANSYS CFD中建立有限元网格,即数值模型。在一定的假设前提下,对支架植入前后的有限元网格分别在ANSYS CFX相同的配置边界条件后并进行计算,得出支架植入前后的动脉瘤模型的壁面切应力、流线、速度场、压力场等的结果,并对支架植入前后的动脉瘤血流动力学特征与进行分析比较并得出统计学结果。
结果：支架植入后动脉瘤的壁面切应力明显降低,动脉瘤内的复杂流场变成简单流场,动脉瘤壁的压力场无明显变化。支架术前后动脉瘤远侧壁、动脉瘤顶的壁面切应力有统计学差异(P=0.003,P=0.001)；支架术前后动脉瘤近侧壁的壁面切应力无统计学差异(P=0.13)；支架术前后动脉瘤远侧壁、动脉瘤顶、动脉瘤近侧壁的压力的无统计学差异(P>0.01)。
结论：支架植入术后可改变动脉瘤的壁面切应力和动脉瘤内流场等血流动力学参数,可能对动脉瘤的愈合创造有利条件。
第三部分：支架植入对动脉瘤内血流动力学影响的数值模拟研究与动物实验对比研究
目的：通过支架植入术后血流动力学数值模拟研究结果与实验研究结果的比较探索支架植入后的血流动力学变化与动脉瘤愈合的关系。
方法：将动脉瘤模型根据复查造影是否显影分为两组：愈合组10例,未愈合组4例。对两组的支架术前后的壁面切应力和压力等血流动力学变化进行比较并得出统计学结果。
结果：愈合组和未愈合组的支架术前后的壁面切应力和压力等血流动力学的变化有明显差别,但是无统计学差异(P>0.01)。
结论：本研究表明数值模拟研究中发现的支架术后壁面切应力的变化与动脉瘤的愈合相关,需更更大样本的数值模拟研究模型进一步对血流动力学的变化及其与临床结果的相关性进行研究。
Part one:Establishment of rabbit-specific numerical intracranial aneurysm model and analysis of hemodynamics
Objective:To establish a numerical model of rabbit-specific aneurysm model based on 3D rotation angiography image and analyze the hemodynamic characters of the aneurysms.
Methods:we established histologically simulating human aneurysms by using elastase to digest the right common carotid artery.The 3DRA images of 16 rabbit-specific aneurysm models were transferred into 3 DM AX then GEOMAGIC for being segmented and smoothed surface data. The surface data was imported into ANSYS CFD in order to create finite element grids. After meshing, we applied ANSYS CFX to create configuration files for fluid field computations and structural mechanics computations respectively, which include the setting of material properties, boundary condition and time step. At last we obtained the hemodynamic parameters including wall shear stress, streamline, velocity profile and pressure profile.
Results:We analyzed hemodynamic characters of rabbit-specific aneurysm models including WSS distribution, maximum WSS, streamline, intra-aneurysmal flow pattern, velocity profile, velocity and width of inflow jet, location and size of impaction zone.
Conclusion:The hemodynamic characters of rabbit-specific aneurysm model are well consistent with that of the human intracranial aneurysm.
Part two:Study of hemodynamic changes induced by virtual placement of the high porocity stent across rabbit-specific aneurysm
Objective:The goal was to study the effects of the high porocity stent on aneurysm hemodynamics using computational fluid dynamics.
Methods:We obtained the DRA images of 14 rabbit-specific aneurysm models and the Micro-computed tomographic angiography images of the stent samples extracted from rabbits treated by solo stent.computed tomographic angiography images. The geometries of rabbit-specific aneurysm models were reconstructed from the DRA images. The geometry of high porocitystents were reconstructed from the computed tomographic angiography images.To deploy the stent in the aneurysm models, the part geometries of the stents were virtually deformed to fit into the parent vessel lumen across the aneurysm neck. The separately reconstructed aneurysm and stent geometries were merged in a single model in ICEM-CFD and meshed. After meshing, we applied ANSYS CFX to create configuration files for fluid field computations and structural mechanics computations respectively, which include the setting of material properties, boundary condition and time step. At last we obtained the hemodynamic parameters including wall shear stress, streamline, velocity profile and pressure profile of both the stented and the unstented aneurysms Some comparisons of the hemodynamic characters of the stented aneurysms with that of the unstented aneurysms including WSS, streamline, intra-aneurysmal flow pattern, velocity profile, velocity and width of inflow jet, location and size of impaction zone were also made
Results:the elevated WSS area was more significantly reduced by stenting,The complex flow pattern observed in the unstented aneurysm was suppressed by stenting.but the pressure on the inner wall of the pressure of the aneurysm was not suppressed by stenting. Stent placement lowered the wall shear stress in the aneurysm, In the stented and unstented aneurysms paring research, there was significant statistic difference in the WSS magnitude on the dome and the distal pouch of the aneurysm between the stented aneurysms group and the unstented aneurysms group (P<0.01),but there was no significant statistic difference in the WSS on the proximal wall near the neck(P=0.13).There was also no significant statistic difference in the pressure on the dome and that on the inner wall of the aneurysm near the proximal and distal pouch of the aneurysm(P>0.01).
Conclusion:Aneurysm hemodynamic parameters were significantly modified by placement of low porocity stents.
Part three:Comparison of the results of numerical and experimental studies in the stented rabbit-specific aneurysm model
Objective:To investigate the different hemodynamic characters in the healed and the unhealed aneurysms and characterize possible associations with the occlusion of the aneurysms.
Methods:We devided the 14 rabbit-specific aneurysm models intotwo groups:the healed group (n=10) and the unhealed group (n=4), according to the follow-up angiography. Some comparisons of the hemodynamic characters of the healed aneurysms with that of the unhealed aneurysms including WSS, pressure were made.
Results:In the paring research, There was significant difference between the two groups,although there was no significant statistic difference in the WSS magnitude on the dome and the distal pouch of the aneurysm between the heaed aneurysms group and the unhealed aneurysms group (P>0.01).
Conclusion:The computed results are verified by experimental studies.further investigation are needed in this area in larger series.
引文
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