Abstract：Objective To explore the changes and the significance of the aerodynamic parameters in the tracheal and bronchial stenosis.Methods From January 2011 to December 2015, clinical, imaging and pulmonary function data of 40 patients with tracheal and bronchial stenosis (the stenosis group) and 40 healthy people(the control group) were retrospectively collected in the Affiliated Hospital of Xuzhou Medical College. The stenosis group was further subgrouped as the tracheal stenosis group and the bronchia stenosis group, each subgroup consisted of 20 patients, among which 38 patients with malignant stenosis, 30 patients with a degree of stenosis greater than 50%, 20 patients with extraluminal stenosis, 22 patients with diffuse stenosis and 37 patients with eccentric stenosis. The DICOM data were acquired using the spiral CT machine and the geometric models of airways were established using the three dimensional reconstruction software. The pulmonary function data were imposed on the inlet and outlet of the geometric models. Then the aerodynamics of the airways were simulated using the computational fluid dynamic software. Aerodynamic parameters of the sectional area, velocity and volume flow at the region of interests were recorded and statistically analyzed. Different parameters between two groups were compared using paired t-test.Results The aerodynamic research models were all established. The velocity at the stenotic site of trachea and bronchia was (1 764±1 484) cm/s, (310±99) cm/s and the volume flow was (1 565±963) mL/s, (156±57) mL/s, which was higher than the velocity at the inlet site of trachea and bronchia and the volume flow (P<0.05 or P<0.01). In the patients with bronchial stenosis, the velocity and volume flow at the inlet of the affected side of bronchia was (82±35) cm/s and (79±32) mL/s, which was lower than velocity and volume flow at the inlet of the unaffected side of bronchia, that was (211±83) cm/s and (184±68) mL/s. In 15 patients with eccentric stenosis, the velocity and volume flow at the inlet of bronchia on the same side of the primary lesions was (464±246) cm/s, ( 526±283) mL/s, which was higher than velocity and volume flow at the inlet of the bronchia on the contralateral side of the primary lesions, that was (308±209) cm/s and (359±255) mL/s(all P values<0.05). Differences in comparison of velocity and volume flow at the site of inlet and middle of tracheal and bronchia in the healthy controls had no statistical significance (all P values>0.05).Conclusions Pathological changes of the aerodynamic parameters exist in patients with tracheal and bronchial stenosis. Tracheal stenosis caus high velocity and volume flow in the stenotic area, also eccentric tracheal stenosis affected airflow at the two sides of bronchi. While bronchia stenosis causes decreased airflow entering into the affected side.Simulation of computer aerodynamic parameters can integrate a variety of inspection data. It provides a comprehensive evaluation method for breathing pathology and physiology research and illness condition assessment.
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Zhang Ke, Wei Ning, Xu Hao, Gao Chuanju.. Changes and clinical significance of the computer aerodynamic simulated parameters in the tracheal and bronchial stenosis. Chinese Journal of Anatomy and Clinics, 2017, 22(1): 23-28.
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