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目的探讨不同肝右静脉与下腔静脉夹角变化对布-加综合征患者下腔静脉隔膜发生机制的影响。方法运用Mimics软件对临床磁共振成像血管造影下腔静脉和主要肝静脉图像进行三维实体模型重建,测得正常模型下腔静脉与肝右静脉夹角为56°。在保持模型基本结构不变基础上,分别构建肝右静脉与下腔静脉夹角为30°和120°的模型,并数值模拟计算3个模型的壁面剪切力、壁面压强、速度分布。结果 3个模型壁面压强、壁面剪切力差异显著。与正常人56°模型相比,30°模型有较高的壁面压强和较低的血液流速,120°模型有较低的壁面剪切力和血液流速,并伴随有涡流的出现,这些血流动力学因素的改变更易于血栓的形成。56°模型血管内血流流速最快。结论对下腔静脉与肝右静脉血液流场的数值模拟有助于了解布-加综合征的发病机制,提高下腔静脉阻塞隔膜形成风险的预测,为治疗提供理论依据。
Objective To investigate the effect of different angles between different right hepatic veins and inferior vena cava on the mechanism of inferior vena cava in Budd-Chiari syndrome. Methods The Mimics software was used to reconstruct the 3D images of the inferior vena cava and the main hepatic vein in MR angiography. The angle between the inferior vena cava and the right hepatic vein in the normal model was 56 °. On the basis of maintaining the basic structure of the model, the models of 30 ° and 120 ° angles between the right hepatic vein and inferior vena cava were constructed, and the wall shear stress, wall pressure and velocity distribution of the three models were numerically simulated. Results The wall pressure and wall shear force of the three models were significantly different. Compared with the normal 56 ° model, the 30 ° model has a higher wall pressure and lower blood flow rate, the 120 ° model has lower wall shear force and blood flow velocity, accompanied by the presence of vortices Changes in kinetic factors make thrombosis easier. 56 ° model blood flow within the blood flow the fastest. Conclusion The numerical simulation of the blood flow in the inferior vena cava and the right hepatic vein helps to understand the pathogenesis of Budd-Chiari syndrome and improve the prediction of the risk of occlusion of inferior vena cava occlusion, providing a theoretical basis for treatment.