Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies

作者：Simone Saitta, Baolei Guo, Selene Pirola, Claudia Menichini, Daqiao Guo, Yan Shan, Zhihui Dong, Xiao Yun Xu, Weiguo Fu · 发表于：Frontiers in Bioengineering and Biotechnology · 年份：2021 · DOI：10.3389/fbioe.2021.742985 · 被引用次数：16 · 研究领域：Aortic Disease and Treatment Approaches、Aortic aneurysm repair treatments、Cardiac Valve Diseases and Treatments

Objective: The interactions between aortic morphology and hemodynamics play a key role in determining type B aortic dissection (TBAD) progression and remodeling. The study aimed to provide qualitative and quantitative hemodynamic assessment in four different TBAD morphologies based on 4D flow MRI analysis. Materials and Methods: Four patients with different TBAD morphologies underwent CT and 4D flow MRI scans. Qualitative blood flow evaluation was performed by visualizing velocity streamlines and flow directionality near the tears. Quantitative analysis included flow rate, velocity and reverse flow index (RFI) measurements. Statistical analysis was performed to evaluate hemodynamic differences between the true lumen (TL) and false lumen (FL) of patients. Results: Qualitative analysis revealed blood flow splitting near the primary entry tears (PETs), often causing the formation of vortices in the FL. All patients exhibited clear hemodynamic differences between TL and FL, with the TL generally showing higher velocities and flow rates, and lower RFIs. Average velocity magnitude measurements were significantly different for Patient 1 ( t = 5.61, p = 0.001), Patient 2 ( t = 3.09, p = 0.02) and Patient 4 ( t = 2.81, p = 0.03). At follow-up, Patient three suffered from left renal ischemia because of FL collapse. This patient presented a complex morphology with two FLs and marked flow differences between TL and FLs. In Patient 4, left renal artery malperfusion was observed at the 32-...