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研究生: 胡晉銘
Chin-ming Hu
論文名稱: 肺動脈高壓病患的血液動力學特性之相位對比磁振造影分析
Assessment of hemodynamic characteristics in patients with pulmonary hypertension using phase contract magnet resonance image
指導教授: 陳明志
Ming-jyh Chern
口試委員: 吳銘庭
Ming-ting Wu
林益如
Yi-ru Lin
學位類別: 碩士
Master
系所名稱: 工程學院 - 機械工程系
Department of Mechanical Engineering
論文出版年: 2013
畢業學年度: 101
語文別: 英文
論文頁數: 55
中文關鍵詞: 肺動脈高壓相位對比磁共振成像平均剪應力震盪剪應力
外文關鍵詞: Pulmonary arterial hypertension, Phase contrast magnetic resonance imagining, Average wall shear stress, Oscillatory shear index
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  • 肺動脈高壓是由於肺動脈流阻增加進而造成流量減少的綜合症,影響範圍包括心臟及肺部, 會逐
    漸引起右心室衰竭。本研究主要目的是為了分析肺動脈高壓與血液動力學之間的關係, 調查健康
    者與肺動脈高壓病患之間在肺動脈內血液動力學的差異。相位對比磁共振成像的技術可以獲取
    人體肺動脈內真實的血流情況, 本研究利用此技術共分析44位案例(24位健康,12位高阻力型肺
    動脈高壓及8位高流量型肺動脈高壓) 的流場型態、壓力分佈、平均壁面剪應力和平均震盪剪應
    力和壁面剪應力及振盪剪應力的變異系數在正常者與肺動脈高壓病患之間的差異。除了上述這
    些現象之外, 我們也計算了正常和病變樣本在肺動脈中的相對面積變化、脈波速度、肺動脈流阻
    以及評估雷諾數。


    Pulmonary arterial hypertension (PAH) is a syndrome resulting from decreased flow of
    blood in the pulmonary vasculature due to increased pulmonary vascular resistance (PVR)
    and this disease affects both the heart and lungs. A total of 44 cases (24 healthy volunteers,
    12 patients with PAH-HR and 8 patients with PAH-HV) are analyzed to explain the
    difference of hemodynamics between the healthy PA and PAH and to find out pathogenesis
    of PAH. To investigate the relationship between hemodynamics and PAH, we use the
    Phase Contrast Magnetic Resonance Imaging (PC-MRI) to calculate physical quantities.
    Flow patterns, pressure distribution, relative area change (RAC), pulse wave velocity
    (PWV), blood volumetric flow rate (Q) and Pulmonary vascular resistance (PVR) are
    measured in PA , mean value of average wall shear stress (Ms) and oscillatory shear index
    (Mo), the coefficient of variance of average wall shear stress (CVs) and oscillatory shear
    index (CVo).

    CONTENTS Chinese Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii 致謝. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii Nomenclatures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi 1 INTRODUCTION 1 1.1 Motivation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Literature review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 PC-MRI measurement and analysis 8 2.1 Image acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 · iv · 2.2 Image processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 2.3 Raw data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2.4 Physical parameters of blood . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2.4.1 Calculation of pressure . . . . . . . . . . . . . . . . . . . . . . . . . 11 2.4.2 Relative area change (RAC) and Pulse wave velocity (PWV) . . . . 13 2.4.3 Pulmonary vascular resistance (PVR) . . . . . . . . . . . . . . . . . 14 2.4.4 Calculation of shear stress . . . . . . . . . . . . . . . . . . . . . . . 14 2.4.5 The coefficient of variance of AWSS (CVs) and OSI (CVo . . . . . . 16 3 RESULTS AND DISCUSSION 19 3.1 Analysis of flow patterns and pressure distribution . . . . . . . . . . . . . . 19 3.1.1 Main pulmonary artery . . . . . . . . . . . . . . . . . . . . . . . . . 20 3.1.2 Left pulmonary artery . . . . . . . . . . . . . . . . . . . . . . . . . 21 3.1.3 Right pulmonary artery . . . . . . . . . . . . . . . . . . . . . . . . 23 3.2 Relative area change and Pulse wave velocity . . . . . . . . . . . . . . . . . 24 3.3 Blood volumetric flow rate and pulmonary vascular resistance . . . . . . . 25 3.4 Analysis of shear stress distribution . . . . . . . . . . . . . . . . . . . . . . 27 3.4.1 Coefficient of variance of AWSS (CVs) and OSI (CVo) . . . . . . . . 28 4 CONCLUSIONS AND FUTURE WORKS 31 · v · 4.1 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 4.2 Future Works . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 BIBLIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 · vi

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