臺灣博碩士論文加值系統

肺動脈高壓是一種由於肺部阻力增加而造成脈管系統血流減少的綜合症狀, 對於心臟以及肺部
具有嚴重的影響性。研究目的主要是分析PAH 與血液動力學之間的關係, 觀察正常人與具有
PAH 患者的差異, 試著找出PAH 的發病機制。在此篇文章中, 總共分析了69組資料(25位健
康者, 31位高流阻力型肺動脈高壓及13位高流量型肺動脈高壓患者), 使用相位對比磁共振成像
技術可以獲取人體肺動脈內真實的血流情況, 並且計算統計學上群組之間的關聯性。利用流場型
態、壓力分佈、相對面積變化、脈波速度、血液體積流率、肺動脈流阻、平均壁面及震盪剪應力、
壁面剪應力及振盪剪應力的變異系數等多項血液動力學參數進行分析。

Pulmonary arterial hypertension (PAH) is a syndrome leading to the reduction of blood flow in the pulmonary vasculature due to increasing pulmonary vascular resistance (PVR). This disease has a serious influence on both the heart and lungs. A total of 69 cases (25 healthy volunteers, 31 patients with PAH-HR (high flow resistance) and 13 patients with PAH-HV (high volumetric flow rate)) are analyzed to investigate the difference of hemodynamics between the healthy pulmonary artery and PAH. Furthermore, the pathogenesis of PAH is also discussed. The Phase Contrast Magnetic Resonance Imaging (PC-MRI) and statistical analysis are used to calculate and analyze physical quantities in order to investigate the relationship between hemodynamics and PAH. Flow patterns, pressure distribution, relative area change (RAC), pulse wave velocity (PWV), blood volumetric flow rate (Q), pulmonary vascular resistance (PVR), mean value of average wall shear stress (Ms), oscillatory shear index (Mo), the coefficient of variance of average wall shear stress (CVs) and oscillatory shear index (CVo) are measured in pulmonary artery.

CONTENTS
Chinese Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
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 . . . . . . . . . . . . . . . . . . .9
2.1 Image acquisition . . . . . . . . . . . . . . .. . . . . . . . . . . 10
2.2 Image processing . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.3 Physical parameters of blood . . . . . . . . . . . . . . . . . . . . 12
2.3.1 Calculation of pressure . . . . . . . . . . . . . . . . . . . . . 12
2.3.2 Relative area change (RAC) and Pulse wave velocity (PWV) . . . . . 14
2.3.3 Pulmonary vascular resistance (PVR) . . . . . . . . . . . . . . . 15
2.3.4 Calculation of shear stress . . . . . . . . . . . . . . . . . . . 15
2.3.5 The coefficient of variance of AWSS (CVs) and OSI (CVo . . . . . . 18
3 RESULTS AND DISCUSSION 20
3.1 Analysis of flow patterns and pressure distribution . . . . . . . . 20
3.1.1 Main pulmonary artery . . . . . . . . . . . . . . . . . . . . . . 21
3.1.2 Left pulmonary artery . . . . . . . . . . . . . . . . . . . . . . 22
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 . . . . . . . . . . . . . .. . 26
3.4.1 Coefficient of variance of AWSS (CVs) and OSI (CVo) . . . . . . . 27
4 CONCLUSIONS AND FUTURE WORKS . . . . . . .. . . . . . .. . . . . . 29
4.1 Conclusions . . . . .. . . . . . . . . . . . . . . . . . . . . . . . 29
4.2 Future Works . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
BIBLIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

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