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Validation of classification system for isolated superior mesenteric artery dissections using image-based computational flow analysis.
Zhang, Xuehuan; Chen, Jiale; Qiu, Chenyang; He, Yangyan; Wang, Bing; Zhang, Hongkun; Wu, Ziheng; Chen, Duanduan.
Afiliación
  • Zhang X; School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China.
  • Chen J; School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China.
  • Qiu C; Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou 310000, China.
  • He Y; Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou 310000, China.
  • Wang B; Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou 310000, China.
  • Zhang H; Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou 310000, China.
  • Wu Z; Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou 310000, China. Electronic address: wuziheng@zju.edu.cn.
  • Chen D; School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China.
Comput Methods Programs Biomed ; 255: 108364, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39146760
ABSTRACT
BACKGROUND AND

OBJECTIVE:

The isolated superior mesenteric artery dissection (ISMAD) is a rare but potentially fatal vascular disorder. Classifications for ISMAD were previously proposed based on morphometric features. However, the classification systems were not standardized and verified yet. This study conducted computational flow analysis to validate the latest classification system of ISMAD and aid clinical decision-making based on hemodynamic parameters.

METHODS:

62 patients with ISMAD were included and classified into different types according to false lumen structures (five types, Type I-V) and true lumen patency (two types, Type P and Type S) according to Qiu classification system. Computational fluid dynamics and three-dimensional structural analyses were conducted on the basis of computed tomography angiography datasets. Quantitative and qualitative functional analyses were performed via parameters of interest including volume flow of each minute, pressure drop, pressure gradient, the derivative parameters of wall shear stress such as time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and the relative residence time (RRT). Statistical analyses were conducted among different ISMAD types.

RESULTS:

TAWSS, OSI and RRT showed significant difference among different types when classified using false lumen structures. In detail, Type IV showed significantly higher TAWSS than other types (p = 0.007). OSI was obviously higher in Type II (p = 0.015). Type IV also presented the lowest RRT (p = 0.005). The pressure drop, pressure gradient, OSI and RRT showed higher value in Type S than that in Type P, demonstrating a statistical significance with p values of 0.017, 0.041, 0.001 and 0.012, respectively. While Type P had larger volume flow than Type S (p = 0.041).

CONCLUSIONS:

The notable differences in hemodynamic features among different types demonstrated the feasibility of Qiu classification system. The evaluation based on hemodynamic simulation might also provide insights into risk identification and guide therapeutic decisions for ISMAD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arteria Mesentérica Superior / Hemodinámica / Disección Aórtica Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Comput Methods Programs Biomed Asunto de la revista: INFORMATICA MEDICA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Irlanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arteria Mesentérica Superior / Hemodinámica / Disección Aórtica Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Comput Methods Programs Biomed Asunto de la revista: INFORMATICA MEDICA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Irlanda