Hemodynamic Analysis and CFD Model Optimization in Stanford Type B Aortic Dissection

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K22889
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0902:General internal medicine and related fields
• Research Institution: Tohoku University
• Principal Investigator: Higuchi Satoshi 東北大学, 大学病院, 医員 (90876715)
• Project Period (FY): 2020-09-11 – 2022-03-31
• Keywords: 大動脈解離 / Stanford B型 / 慢性期 / 4D flow MRI / CFD / 血流動態

Outline of Final Research Achievements

Stanford type B aortic dissection is associated with late complications due to false lumen enlargement in the chronic phase. We have demonstrated that the hemodynamics in the true and false lumen are very complex in patients with false lumen enlargement, and that the blood flow is not only from the true lumen into the false lumen, but also flows back into the true lumen once it has entered the false lumen. We also showed that hemodynamic parameters derived from 4D flow MRI were associated with the false lumen diameter enlargement rate. On the other hand, such complex hemodynamics are difficult to reproduce by CFD, which is a computer simulation based on vessel morphology. It turns out that CFD needs to be recognized as a separate modality from 4D flow MRI for hemodynamic assessment rather than creating an appropriate model.

Free Research Field

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Academic Significance and Societal Importance of the Research Achievements

4D flow MRIによって評価した血行動態のパラメータは慢性期Stanford B型大動脈解離の血管径拡大率の予測に寄与することを示したことで、4D flow MRIによる血流動態評価はより早期に治療介入が必要な患者の選別や合併症発生のリスク層別化に寄与することができると考えられる。また、CFDによる血流動態評価は4D flowの血流動態を再現することが困難であることがわかったことで、今後は4D flow MRIとは別のモダリティとして血管径拡大率の予測が可能かどうかを検討する必要があることがわかった。