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目的通过对上矢状窦旁桥静脉的血流动力学数值模拟,为脑静脉血栓形成发病机制的解释和影像学诊断提供形态学证据。方法对6例(12侧)上矢状窦和颈内静脉灌注蓝色乳胶的成人头颅湿标本进行观测,测量各支桥静脉的直径及其注入上矢状窦的角度;利用解剖数据,应用计算流体力学分析软件Fluent,建立上矢状窦旁桥静脉的血流动力学模型,对不同模型的壁面剪切力进行比较分析。结果上矢状窦旁桥静脉共计137支,分为前后两组,其中后组桥静脉的直径较大,注入上矢状窦的角度较小。共建立模型137个,桥静脉直径>1.2mm、65°≤注入角度<105°时,注入处下游上矢状窦壁壁面剪切力下降明显;桥静脉直径>1.2mm、注入角度<65°时,注入处下游上矢状窦壁和注入处上游桥静脉壁壁面剪切力下降明显,桥静脉壁壁面剪切力最低值为上矢状窦壁上的63%。与前段组桥静脉模型相比较,后段组模型上矢状窦壁和桥静脉壁壁面剪切力最低值较小,距注入处较远。结论桥静脉直径>1.2mm,且注入角度<65°时,血管壁面剪切力急剧下降,脑静脉血栓形成容易发生。血栓好发于上矢状窦后段的注入处上游桥静脉壁。
Objective To provide morphological evidence for the interpretation of the pathogenesis of cerebral venous thrombosis and imaging diagnosis by the numerical simulation of the hemodynamics of the superior sagittal sinus. Methods 6 cases (12 sides) of the upper sagittal sinus and jugular vein were infused with blue latex in adult skull wet specimens to measure the diameter of each branch of the vein and its injection into the superior sagittal sinus angle; the use of anatomical data, the application of Computational fluid dynamics analysis software Fluent was used to establish the hemodynamic model of the superior sagittal sinus veins. The wall shear forces of different models were compared and analyzed. Results The superior sagittal sinus veins total of 137, divided into two groups before and after, in which posterior group of the larger diameter of the vein, the injection of the superior sagittal sinus angle smaller. A total of 137 models were established, the diameter of the bridge vein> 1.2mm, the angle of 65 ° ≤ the injection angle <105 °, and the shear force on the wall of the superior sagittal sinus decreased significantly. The diameter of the bridge vein> 1.2mm and the implantation angle <65 ° , The shear force of the upper sagittal sinus wall and the upstream bridge vein wall at the injection site decreased obviously, and the minimum value of the shear force on the wall of the bridge vein wall was 63% of the upper sagittal sinus wall. Compared with the anterior segment group, the lowest shear force on the wall of sagittal sinus and bridging vein in the posterior segment group was smaller and far from the injection site. Conclusion When the diameter of the bridge vein is> 1.2mm and the implantation angle is less than 65 °, the shear force on the wall of the vessel drops sharply and the venous thrombosis is easy to occur. Thrombus occurs in the superior sagittal sinus posterior segment of the injection site upstream of the venous bridge.