摘要
目的建立个体化肝硬化门静脉高压模型,比较经颈静脉肝内门体分流术(TIPS)不同分流方案的差异。方法选取1例肝硬化门静脉高压患者并测量数据。采用MIMIC软件建立9种分流方案模型,通过Fluent软件计算后导入计算流体力学(CFD)-Post软件行后处理。比较不同分流方案中门静脉压下降比、门静脉入肝血流比、分流道内来自肠系膜上静脉血流比,采用综合评价系数G进行优劣性评价。结果分流道位置相同时,分流道直径越大,门静脉压下降越多、门静脉入肝血流越少,其中分流道直径为6 mm时不能充分降压。分流道直径相同时,分流道内来自肠系膜上静脉血流比为门静脉右支分流>主干分流>左支分流。G值在门静脉左支8 mm直径分流方案中最高。结论TIPS术经门静脉左支构建直径为8 mm分流道方案的预期效果最佳。
Objective To establish an individualized cirrhotic portal hypertension model,and to compare different shunting schemes in transjugular intrahepatic portosystemic shunt(TIPS).MethodsOne cirrhotic patient with portal hypertension was selected and the relevant data were collected.The software MIMIC was used to establish 9 models of different shunting schemes,then,after the calculation by Fluent software all models data were input into computer for processing by CFD-Post software.The portal vein pressure drop ratio,flow ratio from portal vein to liver,and flow ratio from the superior mesenteric vein in the shunt tract were compared between the different shunting schemes.The coefficient G was adopted to evaluate the pros and cons.ResultsWhen the location of the shunt was same,the larger the diameter of the shunt was,the lower the portal vein pressure and the less the hepatic blood perfusion from portal vein would be.When the diameter of shunt was 6mm,the drop of portal vein pressure was insufficient.When the shunt diameter was same,the flow ratios from superior mesenteric vein in the shunt were characterized by the following order:right branch shunt of portal vein>trunk shunt>left shunt.The highest G value was seen in 8mm-diameter shunting scheme through the left branch of portal vein.ConclusionIn TIPS treatment,an 8mm-diameter shunting scheme through the left branch of portal vein carries the best expected effect.
作者
曹俊杰
姚志超
刘占鳌
汤尧
黄剑
陈旻昕
周大勇
沈利明
CAO Junjie;YAO Zhichao;LIU Zhanao;TANG Yao;HUANG Jian;CHEN Minxin;ZHOU Dayong;SHENLiming(Department of Vascular Surgery,Suzhou Municipal Hospital,Gusu School of Nanjing Medical University,Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu Province 215002,China)
出处
《介入放射学杂志》
CSCD
北大核心
2023年第1期17-21,共5页
Journal of Interventional Radiology
基金
江苏省苏州市科教兴卫青年科技项目(KJXW2020031)
关键词
经颈静脉肝内门体分流术
门静脉高压症
血流动力学
计算流体力学
transjugular intrahepatic portosystemic shunt
portal hypertension
hemodynamics
computational fluid dynamics
