在体内通过计算流体动力学来预测肝脏流量分布,可以预测Fontan循环患者的肺流量分布
Petter Frieberg1, Pia Sjöberg2, Erik Hedström2,3
1Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden. petter.frieberg@med.lu.se.
Scientific reports
|October 24, 2023
概括
在Fontan患者中,肝脏血液流向肺部的平衡会影响肺血管阻力和氧气和. 这种非侵入性MRI和CFD方法有助于规划Fontan相关的肝脏和肺部并发症的干预措施.
科学领域:
- 心血管医学 心血管医学
- 医疗成像医学成像
- 计算流体动力学的流体动力学.
背景情况:
- 芬坦患者可能会由于肝血流变化而发展出肺动脉静脉形 (PAVM),导致转向和氧化减少.
- 肺血管阻力 (PVR) 和氧和是Fontan生理学中由肝至肺血流动力学影响的关键参数.
研究的目的:
- 在Fontan患者中,非侵入性地确定肝肺血流平衡和肺流量,PVR和氧和之间的相关性.
- 通过了解血流平衡的影响,为纠正性侵入性干预提供指导.
主要方法:
- 使用患者特定的计算流体动力学 (CFD) 模型,这些模型是从18名Fontan患者的磁共振成像 (MRI) 数据中构建的.
- 计算了肝血流到肺血流,并将其与肺静脉流量,模拟的PVR和氧和度相关联.
- 使用干预患者病例验证的发现,将CFD预测与干预后MRI测量进行比较.
主要成果:
- 肝肺血流平衡与右/左肺静脉流量 (R2=0.50),模拟PVR (R2=0.47) 和静止氧和 (R2=0.56) 有显著的相关性.
- 差价合约模型的预测准确地反映了临床病例中的干预后结果.
- 肝肺血流平衡持续影响PVR和氧和,无论PAVM诊断如何.
结论:
- 肝脏血液流向肺部的平衡是影响Fontan患者PVR和氧和的一个关键因素.
- 与CFD相结合的MRI为规划影响肝肺血流平衡的手术和干预策略提供了有价值的非侵入性工具.
- 这种方法可以帮助管理Fontan相关的并发症并优化患者的治疗结果.
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