Article(id=1244321227104432540, tenantId=1146029695717560320, journalId=1244284848500682798, issueId=1244321215637209904, articleNumber=null, orderNo=null, doi=10.16156/j.1004-7220.2025.05.032, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736352000000, receivedDateStr=2025-01-09, revisedDate=1740067200000, revisedDateStr=2025-02-21, acceptedDate=null, acceptedDateStr=null, onlineDate=1774598898911, onlineDateStr=2026-03-27, pubDate=1759248000000, pubDateStr=2025-10-01, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1774598898911, onlineIssueDateStr=2026-03-27, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1774598898911, creator=13701087609, updateTime=1774598898911, updator=13701087609, issue=Issue{id=1244321215637209904, tenantId=1146029695717560320, journalId=1244284848500682798, year='2025', volume='40', issue='5', pageStart='1079', pageEnd='1366', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1774598896178, creator=13701087609, updateTime=1774599509568, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1244323788452639476, tenantId=1146029695717560320, journalId=1244284848500682798, issueId=1244321215637209904, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1244323788452639477, tenantId=1146029695717560320, journalId=1244284848500682798, issueId=1244321215637209904, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1325, endPage=1332, ext={EN=ArticleExt(id=1244321227507085757, articleId=1244321227104432540, tenantId=1146029695717560320, journalId=1244284848500682798, language=EN, title=Flow Behavior of Peritoneal Fluid in Cavity Between the Liver and Diaphragm Peritoneum, columnId=1244321216404767539, journalTitle=Journal of Medical Biomechanics, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the flow field characteristics of peritoneal fluid flowing in the cavity between the liver and the inner wall of the diaphragm peritoneum in patients with ovarian cancer and the effects on deformation of the liver and diaphragm peritoneum.

Methods

A bidirectional fluid-structure interaction (FSI) analysis was conducted using COMSOL to investigate the interaction between the peritoneal fluid and the liver and diaphragm peritoneum under varying inlet velocities and viscosity functions.

Results

The accuracy of the simulation was validated by comparing the simulation results with the contour lines of the CT scans, and the displacement error between the two was smaller than 5%. When the inlet velocity of the abdominal fluid increased from 0.1 m/s to 0.15 m/s, convex deformation of the diaphragm peritoneum increased by 193.3 μm, and concave deformation decreased by 304.1 μm. Meanwhile, the increase of the inlet velocity made the viscosity near the wall of deformed area increased, which improved the probability of the metastatic implantation of the cancer cells. The higher the viscosity in the main body region of the viscosity function, the larger convex deformation of the diaphragm peritoneum; the larger the linear fitting value in the tail, the smaller the concave deformation. The viscosity of the concave deformation area near the outlet of the right lobe was much larger than that of other areas, and cancer cells were more likely to metastasise in this area.

Conclusions

This study elucidates the relationship between peritoneal fluid flow and solid deformation, predicting the regions prone to cancer cell metastasis and implantation under various conditions. The findings provide a theoretical foundation for studying the motion of cancer cells within the flow field.

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目的

探究卵巢癌患者体内腹腔积液在肝脏和膈肌腹膜内壁之间空腔内流动的流场特性以及对肝脏和膈肌腹膜变形的影响。

方法

使用COMSOL中的双向流固耦合分析不同入口速度和黏度函数下腹腔积液与肝脏和膈肌腹膜之间的相互作用。

结果

通过对比模拟结果与CT扫描图的轮廓线,二者位移误差小于5%,证明了模拟的准确性。腹腔积液入口速度从0.1 m/s增至0.15 m/s,膈肌腹膜凸出变形量增加193.3 μm,凹陷变形量减小304.1 μm,同时入口速度增大使得变形区壁面附近黏度增大,提高了癌细胞转移种植的概率。黏度函数主体区域黏度越高,膈肌腹膜凸出变形越大;尾部线性拟合值越大,凹陷变形越小。右叶出口附近凹陷变形区的黏度远大于其他区域,癌细胞更容易在该区域转移。

结论

本研究揭示腹腔积液流动与固体变形之间的关系,预测不同条件下癌细胞易转移种植的部位,为研究流场内癌细胞的运动提供理论基础。

, correspAuthors=null, authorNote=null, correspAuthorsNote=
武锦涛,副教授,E-mail:
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#

为共同第一作者

作者贡献声明:

王嘉琦负责研究实施、数据分析、论文撰写;王胜男负责研究方案设计、研究实施、数据分析;武锦涛负责研究方案设计、数据分析、论文指导与撰写;王宁负责研究方案设计。

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Am J Roentgenol, 1973, 119(1): 198-206., articleTitle=Distribution of intra-abdominal malignant seeding: Dependency on dynamics of flow of ascitic fluid, refAbstract=null)], funds=[Fund(id=1244321240652034397, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, awardId=2021-MS-277, language=CN, fundingSource=辽宁省自然科学基金项目(2021-MS-277), fundOrder=null, country=null), Fund(id=1244321240740114790, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, awardId=LZ2020063, language=CN, fundingSource=辽宁省教育厅科学研究计划项目(LZ2020063), fundOrder=null, country=null), Fund(id=1244321241025327474, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, awardId=2022LCJSZD04; 2022LCJSGC23, language=CN, fundingSource=1+X临床技术水平提升项目(2022LCJSZD04; 2022LCJSGC23), fundOrder=null, country=null), Fund(id=1244321241167933821, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, awardId=2020LCYJYB11, language=CN, fundingSource=1+X计划临床研究孵化项目(2020LCYJYB11), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1244321233827902270, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, xref=1., ext=[AuthorCompanyExt(id=1244321233836290878, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, companyId=1244321233827902270, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.School of Chemical Engineering, Dalian University of Technology, Dalian 116024, Liaoning, China), AuthorCompanyExt(id=1244321233848873793, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, companyId=1244321233827902270, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.大连理工大学 化工学院,辽宁 大连 1160241)]), AuthorCompany(id=1244321233953731408, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, xref=2., ext=[AuthorCompanyExt(id=1244321233957925713, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, companyId=1244321233953731408, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.Second Department of Gynaecology, the Second Hospital of Dalian Medical University, Dalian 116023, Liaoning, China), AuthorCompanyExt(id=1244321233966314322, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, companyId=1244321233953731408, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.大连医科大学附属第二医院 妇科二科,辽宁 大连 116023)])], figs=[ArticleFig(id=1244321238068342910, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Fig. 1, caption=Three-dimensional (3D) model of the liver, diaphragm peritoneum and falciform ligament (a) Liver 3D scanning model, (b) Liver, diaphragmatic peritoneum and sickle ligament model, (c) 3D model including the liver, figureFileSmall=n7QTX8k0+1XM38h8x8D0rA==, figureFileBig=EjhaDJpC+bxvj23Fb0ljdw==, tableContent=null), ArticleFig(id=1244321238160617608, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=图1, caption=肝脏、膈肌腹膜及镰状韧带三维模型

注:图1(b)模型的白色结构为镰状韧带,透明结构为膈肌腹膜,黑色直线为模型切割线,黑线以上部分保留;图1(c)模型的蓝色结构代表肝脏,红色区域为入口,绿色区域为出口,黑色结构为镰状韧带壁面。

, figureFileSmall=n7QTX8k0+1XM38h8x8D0rA==, figureFileBig=EjhaDJpC+bxvj23Fb0ljdw==, tableContent=null), ArticleFig(id=1244321238416470171, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Fig. 2, caption=Viscosity function of the peritoneal fluid and hyperelastic parameter maps of the liver and diaphragm peritoneum (a) Relationship between the viscosity of the peritoneal fluid and the shear rate (five viscosities), (b) Images of experimental data, fitted curves and validation curves, figureFileSmall=VsqnE+42A+zRAyEjUnPdPg==, figureFileBig=kS+6CWtFLiawIDTmbLNmzQ==, tableContent=null), ArticleFig(id=1244321238529716388, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=图2, caption=腹腔积液黏度函数及肝脏和膈肌腹膜超弹性参数图, figureFileSmall=VsqnE+42A+zRAyEjUnPdPg==, figureFileBig=kS+6CWtFLiawIDTmbLNmzQ==, tableContent=null), ArticleFig(id=1244321238651351211, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Fig. 3, caption=Model mesh and irrelevance validation (a) Mesh delineation of the liver, diaphragm peritoneum and fluid domains, (b) Location distribution of five outlet pressure monitoring points, (c) Pressure at five monitoring points for different mesh numbers, figureFileSmall=85sQhFup2capEejDEkUuFw==, figureFileBig=iCBLnLQdspHI9vIjpQLv0w==, tableContent=null), ArticleFig(id=1244321238756208819, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=图3, caption=模型网格及无关性验证

注:图3(c)中网格数指流体域和固体域网格数总和。

, figureFileSmall=85sQhFup2capEejDEkUuFw==, figureFileBig=iCBLnLQdspHI9vIjpQLv0w==, tableContent=null), ArticleFig(id=1244321238873649337, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Fig. 4, caption=Abdominal CT images with simulated displacement views at different planes (a) 25 mm from the lowest point of the liver, (b) 30 mm from the lowest point of the liver, figureFileSmall=AFSxI4b7MfPhbA/gxf1OXQ==, figureFileBig=eH0dgkN1lidWTSKyoB/kWA==, tableContent=null), ArticleFig(id=1244321239033032908, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=图4, caption=不同位置腹部CT图像与模拟位移切面图, figureFileSmall=AFSxI4b7MfPhbA/gxf1OXQ==, figureFileBig=eH0dgkN1lidWTSKyoB/kWA==, tableContent=null), ArticleFig(id=1244321239188222166, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Fig. 5, caption=Deformation contours under different entrance velocities at 3 s (a) At Diaphragmatic peritoneum, (b) At liver surface, figureFileSmall=NN1GiKuIHCYN7BInW9QTKw==, figureFileBig=cnoNlnOiP8hWoCfWMb/kVA==, tableContent=null), ArticleFig(id=1244321239330828515, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=图5, caption=3 s时不同入口速度下变形云图

注:红色圆圈代表凸出变形区,灰色圆圈代表凹陷变形区。

, figureFileSmall=NN1GiKuIHCYN7BInW9QTKw==, figureFileBig=cnoNlnOiP8hWoCfWMb/kVA==, tableContent=null), ArticleFig(id=1244321239460851952, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Fig. 6, caption=Viscosity profiles at different entrance velocities (a) Left lobe of the liver, (b) Right lobe of the liver, figureFileSmall=E5k6JUT6W6jp7zSX9Duq9Q==, figureFileBig=vFm4TqL1MGM4ZrRaSQqAtw==, tableContent=null), ArticleFig(id=1244321239561515260, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=图6, caption=3 s时不同入口速度下黏度切面图

注:图6(a)中入口在右侧,出口在左侧;图6(b)中入口在左侧,出口在右侧(下同)。

, figureFileSmall=E5k6JUT6W6jp7zSX9Duq9Q==, figureFileBig=vFm4TqL1MGM4ZrRaSQqAtw==, tableContent=null), ArticleFig(id=1244321239687344390, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Fig. 7, caption=Viscosity profiles under different viscosity functions at 3 s (a) Left lobe of the liver, (b) Right lobe of the liver, figureFileSmall=OMUtYB5MEvCSE9LVc/RYAg==, figureFileBig=yDlwCHW4Bx5/rGWXnOgc3Q==, tableContent=null), ArticleFig(id=1244321239779619088, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=图7, caption=3 s时不同黏度函数下黏度切面图, figureFileSmall=OMUtYB5MEvCSE9LVc/RYAg==, figureFileBig=yDlwCHW4Bx5/rGWXnOgc3Q==, tableContent=null), ArticleFig(id=1244321239867699480, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Fig. 8, caption=Maximum deformation of solids with different inlet velocities and viscosity functions (a) Maximum concave deformation of the diaphragm peritoneum, (b) Maximum convex deformation of the diaphragm peritoneum, (c) Maximum deformation of the surface of the liver, figureFileSmall=Rshn2pkM4LUm+z9xZa7LLQ==, figureFileBig=yj/dhqSZbsFU2ugVOGnbog==, tableContent=null), ArticleFig(id=1244321240001917220, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=图8, caption=不同入口速度和黏度函数下固体最大变形量, figureFileSmall=Rshn2pkM4LUm+z9xZa7LLQ==, figureFileBig=yj/dhqSZbsFU2ugVOGnbog==, tableContent=null), ArticleFig(id=1244321240140329263, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Tab. 1, caption=

Total number of meshes for different mesh sizes

, figureFileSmall=null, figureFileBig=null, tableContent=
四边形网格尺寸/mm膈肌腹膜四面体网格尺寸/mm肝脏四面体网格尺寸/mm总网格数
最大最小最大最小最大最小
6.411.210 010.04.95010.004.9530 696
2.780.181 017.73.18017.703.1894 919
2.500.181 05.03.1805.003.18143 848
2.050.181 04.23.1804.203.18199 296
1.800.181 05.01.7705.001.77275 047
1.570.024 24.00.7074.651.77335 596
1.560.024 23.00.2654.001.77380 442
1.550.024 22.30.2653.301.77469 477
1.540.024 21.60.2652.901.77517 417
1.530.024 21.40.2652.701.77575 705
), ArticleFig(id=1244321240257769787, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=表1, caption=

不同网格尺寸的网格总数

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四边形网格尺寸/mm膈肌腹膜四面体网格尺寸/mm肝脏四面体网格尺寸/mm总网格数
最大最小最大最小最大最小
6.411.210 010.04.95010.004.9530 696
2.780.181 017.73.18017.703.1894 919
2.500.181 05.03.1805.003.18143 848
2.050.181 04.23.1804.203.18199 296
1.800.181 05.01.7705.001.77275 047
1.570.024 24.00.7074.651.77335 596
1.560.024 23.00.2654.001.77380 442
1.550.024 22.30.2653.301.77469 477
1.540.024 21.60.2652.901.77517 417
1.530.024 21.40.2652.701.77575 705
), ArticleFig(id=1244321240379404614, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=EN, label=Tab. 2, caption=

Diaphragmatic peritoneal deformation at different viscosity curves

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黏度函数肝脏右叶变形量/mm肝脏左叶变形量/μm
最大凹陷最大凸出最大凹陷最大凸出
12.9281.29713.4734.47
22.8221.29713.4634.63
32.9621.28213.4934.10
42.9531.29513.4834.35
52.8921.28913.4834.36
), ArticleFig(id=1244321240484262223, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321227104432540, language=CN, label=表2, caption=

不同黏度函数下的膈肌腹膜变形量

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黏度函数肝脏右叶变形量/mm肝脏左叶变形量/μm
最大凹陷最大凸出最大凹陷最大凸出
12.9281.29713.4734.47
22.8221.29713.4634.63
32.9621.28213.4934.10
42.9531.29513.4834.35
52.8921.28913.4834.36
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肝脏和膈肌腹膜之间空腔内腹腔积液流动行为
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王嘉琦 1 , 王胜男 2 , 武锦涛 1 , 王宁 2
医用生物力学 | 论著 2025,40(5): 1325-1332
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医用生物力学 | 论著 2025, 40(5): 1325-1332
肝脏和膈肌腹膜之间空腔内腹腔积液流动行为
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王嘉琦1, 王胜男2, 武锦涛1 , 王宁2
作者信息
  • 1.大连理工大学 化工学院,辽宁 大连 1160241
  • 2.大连医科大学附属第二医院 妇科二科,辽宁 大连 116023

通讯作者:

武锦涛,副教授,E-mail:
Flow Behavior of Peritoneal Fluid in Cavity Between the Liver and Diaphragm Peritoneum
Jiaqi WANG1, Shengnan WANG2, Jintao WU1 , Ning WANG2
Affiliations
  • 1.School of Chemical Engineering, Dalian University of Technology, Dalian 116024, Liaoning, China
  • 2.Second Department of Gynaecology, the Second Hospital of Dalian Medical University, Dalian 116023, Liaoning, China
出版时间: 2025-10-01 doi: 10.16156/j.1004-7220.2025.05.032
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目的

探究卵巢癌患者体内腹腔积液在肝脏和膈肌腹膜内壁之间空腔内流动的流场特性以及对肝脏和膈肌腹膜变形的影响。

方法

使用COMSOL中的双向流固耦合分析不同入口速度和黏度函数下腹腔积液与肝脏和膈肌腹膜之间的相互作用。

结果

通过对比模拟结果与CT扫描图的轮廓线,二者位移误差小于5%,证明了模拟的准确性。腹腔积液入口速度从0.1 m/s增至0.15 m/s,膈肌腹膜凸出变形量增加193.3 μm,凹陷变形量减小304.1 μm,同时入口速度增大使得变形区壁面附近黏度增大,提高了癌细胞转移种植的概率。黏度函数主体区域黏度越高,膈肌腹膜凸出变形越大;尾部线性拟合值越大,凹陷变形越小。右叶出口附近凹陷变形区的黏度远大于其他区域,癌细胞更容易在该区域转移。

结论

本研究揭示腹腔积液流动与固体变形之间的关系,预测不同条件下癌细胞易转移种植的部位,为研究流场内癌细胞的运动提供理论基础。

卵巢癌  /  腹腔积液  /  肝脏  /  膈肌腹膜  /  癌细胞转移  /  流固耦合
Objective

To investigate the flow field characteristics of peritoneal fluid flowing in the cavity between the liver and the inner wall of the diaphragm peritoneum in patients with ovarian cancer and the effects on deformation of the liver and diaphragm peritoneum.

Methods

A bidirectional fluid-structure interaction (FSI) analysis was conducted using COMSOL to investigate the interaction between the peritoneal fluid and the liver and diaphragm peritoneum under varying inlet velocities and viscosity functions.

Results

The accuracy of the simulation was validated by comparing the simulation results with the contour lines of the CT scans, and the displacement error between the two was smaller than 5%. When the inlet velocity of the abdominal fluid increased from 0.1 m/s to 0.15 m/s, convex deformation of the diaphragm peritoneum increased by 193.3 μm, and concave deformation decreased by 304.1 μm. Meanwhile, the increase of the inlet velocity made the viscosity near the wall of deformed area increased, which improved the probability of the metastatic implantation of the cancer cells. The higher the viscosity in the main body region of the viscosity function, the larger convex deformation of the diaphragm peritoneum; the larger the linear fitting value in the tail, the smaller the concave deformation. The viscosity of the concave deformation area near the outlet of the right lobe was much larger than that of other areas, and cancer cells were more likely to metastasise in this area.

Conclusions

This study elucidates the relationship between peritoneal fluid flow and solid deformation, predicting the regions prone to cancer cell metastasis and implantation under various conditions. The findings provide a theoretical foundation for studying the motion of cancer cells within the flow field.

ovarian cancer  /  peritoneal fluid  /  liver  /  diaphragm peritoneum  /  cancer metastasis  /  fluid-solid coupling
王嘉琦, 王胜男, 武锦涛, 王宁. 肝脏和膈肌腹膜之间空腔内腹腔积液流动行为. 医用生物力学, 2025 , 40 (5) : 1325 -1332 . DOI: 10.16156/j.1004-7220.2025.05.032
Jiaqi WANG, Shengnan WANG, Jintao WU, Ning WANG. Flow Behavior of Peritoneal Fluid in Cavity Between the Liver and Diaphragm Peritoneum[J]. Journal of Medical Biomechanics, 2025 , 40 (5) : 1325 -1332 . DOI: 10.16156/j.1004-7220.2025.05.032
癌症对人类健康构成重大威胁,而卵巢癌是女性生殖系统中最致命的恶性肿瘤之一。卵巢癌通常由卵泡或卵巢表面的上皮细胞发展而来,其死亡率高的原因是癌细胞极易在腹腔内转移[1-2]。卵巢癌晚期通常会形成大量腹腔积液,其携带的癌细胞会扩散到整个腹腔[3-5]。研究表明,癌细胞会随腹腔积液流向肝脏和膈肌腹膜,并发生黏附和转移,肝脏表面和膈肌腹膜内壁是转移种植的主要部位[6]。腹腔积液的入口速度会显著影响流场中各点的压力和速度,使其成为癌细胞转移的重要因素[7]。此外,细胞外液黏度增加已被证明能增强癌细胞的运动和扩散能力,黏度对于癌细胞转移的影响不容忽视[8]
Hernández-Gascón等[9]提出了一种借助磁共振成像数据建立腹部模型几何形状的方法,将腹壁视为不可压缩的超弹性材料。何伟等[10]则借助男性腹部CT图像构建了更加精确的腹部几何形状,评估修补后腹壁和网片的力学行为。Cooney等[11]借助人体腹腔内封闭式热灌注化疗的计算流体动力学(computer fluid dynamics,CFD)模拟,评估了特定风险的位置,优化了治疗方案。Löke等[12]开发了一种包含嵌入肿瘤结节的计算模型,使用三维CFD得到治疗癌症药物输送的最佳温度和速度。
以往关于肝脏与膈肌腹膜间流场的研究相对较少,尤其在双向流固耦合作用及黏度变化对腹腔积液流动与癌细胞迁移影响方面的探索更为有限[13]。传统实验方法难以准确模拟真实的腹腔积液流动环境,不仅耗时耗力,结果也存在较大误差。本文采用高精度3D扫描技术构建肝脏三维模型,能够更精确地捕捉器官表面细节;并基于COMSOL软件中的双向流固耦合模块,分析肝脏与膈肌腹膜之间腔隙内腹腔积液的流动特性,以及两者表面的压力分布与变形情况[14]。研究结果对建立癌细胞运动模型、判断其主要转移靶区具有指导意义,也为揭示癌细胞转移的流体力学机制提供了新的理论依据,展现出重要的临床应用潜力。
使用天远三维扫描仪OKIO-5M对1∶1医用仿真肝脏进行扫描,以构建其三维几何模型[见图1(a)][15]。扫描完成后,利用Materialise Magics与Zbrush软件对模型进行修复,并在其表面构建了高4 mm的镰状韧带。该韧带将肝脏完全分隔为左、右两叶,相应地将流体域划分为左叶流体域与右叶流体域。随后,在距离肝脏表面4 mm、厚度1 mm处,等距生成形状与肝表面一致的简化膈肌腹膜模型。肝脏表面与膈肌腹膜之间的空腔即为流体域[见图1(b)]。
本文重点关注肝脏左叶及右叶与膈肌腹膜之间的流体域,流体进出口均位于肝脏与外部膈肌腹膜之间。为构建最终模型,将肝脏底部及对应膈肌腹膜水平切除,并移除镰状韧带中间区域[见图1(c)]。由于镰状韧带固定于肝脏表面,在其壁面处施加固定约束条件。根据对腹腔积液流动雷诺数的计算,可判定其流动形态为层流。设定腹腔积液密度为1 030 kg/m3[16],肝脏与膈肌腹膜密度均为938 kg/m3[17]。本文未考虑呼吸周期对入口速度的影响,采用恒定速度入口条件。出口设置为压力出口,静压为1个标准大气压,以保证腹腔积液能够自然流出,并避免非物理性回流。
腹腔积液的黏度使用AR2000ex旋转流变仪进行测量,配套转子为直径40 mm的不锈钢平行板,测量方法符合GB/T 12009.3-2009标准。实验所用20例腹腔积液样本均取自大连医科大学附属第二医院的不同患者,从中选取5个代表性样本的黏度参数用于数值模拟[见图2(a)]。这些样本在低剪切速率下表现出复杂的黏度分布规律,因其属于非牛顿流体,在该区间内流变行为显著受分子间相互作用和弱流动性影响,且易受外界干扰,导致数据离散较大。为提高准确性,每个样本的黏度均经多次测量并取平均值。测量结果证实,腹腔积液具有典型的非牛顿流体特性[18]。在测量范围之外,黏度与剪切速率之间呈现近似线性关系。因此,对超出原测量区间的黏度(剪切速率在0~1 s-1之间及大于100 s-1的部分)采用线性拟合方法获取。根据不同剪切速率区间,峰值黏度出现在0~10 s-1范围内,主体黏度对应于10~100 s-1区间,而剪切速率超过100 s-1后黏度变化进入线性区间。各黏度函数在上述不同区间的黏度值及变化率均存在差异。
人体肝脏属于典型的非线性超弹性材料[19]。在生物软组织力学中,Ogden模型是描述此类材料最为常用的本构模型之一[20]。膈肌腹膜在材料特性上与肝脏具有一定相似性,因此同样可采用Ogden超弹性模型进行表征[21]
Kemper等[21]用新鲜人肝进行了51次单轴拉伸实验,得到了在应变速率为0.1 s-1时的应力-应变曲线,通过对实验得到的应力应变曲线分析,选用Ogden一阶模型来表示肝脏和膈肌腹膜的弹性。应力、应变与Ogden一阶参数之间的关系为:
式中:λ为伸长比,即伸长后长度与初始长度之比;σ为应力。通过对应力-应变曲线进行拟合,得到Ogden一阶参数μ=9 290.2 Pa,α=6.662,R2=0.985 6。
对拟合的Ogden一阶超弹性参数的准确性进行验证。Untaroiu等[22]采用狗骨状、厚度为5 mm的新鲜人体肝脏样本进行单轴拉伸实验。基于该实验条件,本文建立了相同的模型,并计算出对应的应力-应变数据。结果表明,模拟所得的验证曲线与实验数据的拟合曲线(黑色)高度吻合。两者之间的决定系数(R2)超过0.9,表明拟合优度良好[见图2(b)]。因此,基于该拟合曲线获得的Ogden一阶超弹性参数与实际实验数据之间的误差处于可接受范围。
肝脏模型的长、宽、高分别为173.25、95.74、104.35 mm。模型划分采用混合网格[23],定义全局网格尺寸(见表1)后,分别指定流体域和固体域的网格尺寸。流体域使用扫掠生成结构化网格,而固体域使用非结构化网格[见图3(a)]。
在流场出口处选择了5个监测点[见图3(b)],测量稳定流动时点的实际压力。结果显示,当网格数超过33万个时,各监测点的压力不再随着网格数量的增多而明显变化,最大误差不超过0.1 Pa[见图3(c)]。综合考虑计算时间和精度,最终选择了34万个网格数。
采用第1种黏度函数,将模拟得到的膈肌腹膜变形轮廓线与计算机断层(computed tomography,CT)扫描图像进行对比。选取距离肝脏最低点25 mm和30 mm的两个横截面,用于比较膈肌腹膜在相应位置的位移情况。CT图像清晰显示了膈肌腹膜的轮廓,其中右叶结构较为明显,故本文主要针对右叶区域进行分析。
在区域1中,CT图像显示出明显的交替凹陷与凸起轮廓。位于肝脏右叶上方的凹陷区域与模拟位移切面图中相应位置的形态吻合良好。在25 mm平面处,最大位移为1.87 mm,误差为4.3%;在30 mm平面处,最大位移为1.99 mm,误差为5.1%。该结果表明,该区域的模拟结果与CT图像具有较高一致性。在区域2中,CT图像轮廓相对平滑,局部存在轻微凸起及平直区段。模拟位移切面图显示,对应凸起部位的位移介于1.0~1.2 mm,平直区段的位移则在0.8~0.9 mm,误差均小于5%,进一步验证了模拟与实测结果之间的吻合程度(见图4)。
综上所述,模拟所得位移切面图与实际CT图像的轮廓线高度一致,表明该模拟方法合理可靠,并具有一定的现实意义。
本文分析了入口速度在0.10~0.15 m/s范围内共6种不同速度及5种黏度函数条件下腹腔积液的流动特性及其对固体变形的影响[24]。重力方向设置为沿Y轴正方向,以模拟人体平卧姿态。计算采用的时间步长为1 ms,总计算时长为3 s。选择3 s作为瞬态计算时长的原因是:流体质点从入口运动至出口所需时间小于3 s,且流体域入口处的速度波形在3 s前已趋于稳定。
研究选用第1种黏度函数。结果显示,最大变形出现在右叶出口附近。该区域因膈肌腹膜凹陷导致流道狭窄,增加了癌细胞与壁面接触的几率,从而提高了癌细胞转移和种植的可能性。随着入口速度增大,腹腔积液的初始动能上升,对膈肌腹膜表面的冲量增强,导致其凸出变形量增加,凹陷变形量减小[见图5(a)]。同时,入口速度提高也增大了积液对肝脏表面向上的冲击力,该力方向与重力正方向相反,部分抵消了重力作用,使得肝脏表面沿重力方向的变形逐渐减小[见图5(b)]。具体而言,当入口速度为0.1 m/s时,右叶膈肌腹膜的最大凸出变形量为1.299 mm,最大凹陷变形量为2.928 mm;左叶相应值分别为344.7 μm(凸出)和13.47 μm(凹陷);肝脏表面最大变形量为271.6 μm。当入口速度增至0.15 m/s时,右叶膈肌腹膜的最大凸出变形量为1.492 mm,最大凹陷变形量为2.624 mm;左叶相应值分别为478.5 μm(凸出)和13.02 μm(凹陷);肝脏表面最大变形量为270.4 μm。
第1种黏度函数所描述的黏度变化表现为:随剪切速率增大,黏度先上升,后下降,再次上升,最终趋于稳定。为更清晰观察流体域内黏度的分布情况,本文对多个yz切面的黏度分布进行了分析。切面均取自yz平面,其中左叶选取7个,右叶选取15个。结果显示,无论左叶或右叶,随着入口速度增大,膈肌腹膜的凸出变形量增加,凹陷变形量减小,同时变形区壁面附近速度梯度增大,导致黏度上升(见图6)。因此,入口速度增大时,癌细胞在变形区域内更易发生转移和种植。
在右叶流体域的中心区域可观察到明显的高黏度区。这是由于随着流动持续发展,流体域内部逐渐趋于稳定流动状态,中心区域速度梯度较小,剪切速率较低,使得流体黏度接近黏度函数的峰值,从而表现出较高的黏性。随着入口速度的提高,腹腔积液达到稳定流动所需的时间延长,导致高黏度区域相应向后移动。
在入口速度为0.1 m/s条件下,不同黏度函数所对应的变形区域类型基本一致,但变形量存在差异(见表2)。左叶因体积较小且壁面固定支撑占比较高,其变形量变化并不显著。在右叶的主流区域中,黏度接近黏度函数的终值,处于1.2~1.7 mPa·s之间。前两种黏度函数下腹腔积液的黏度明显高于后3种,较高的黏度增大了流体流动阻力,并导致作用于固体壁面的剪应力增加,使得膈肌腹膜主流区域的凸出变形量较后3种黏度函数高约1%。在膈肌腹膜的凹陷变形区,黏度函数线性区间内的黏度值与凹陷变形量呈正相关,黏度越大,凹陷变形量也越大。相比之下,肝脏表面的变形量变化极小,幅度不超过0.1%。
图7所示切面的选取与图6保持一致。在左叶中,变形区壁面附近的剪切速率处于黏度函数线性区间内。其中,第2、5种黏度函数在该区间内增长率较高,因此该区域壁面黏度显著高于其他3种黏度函数,导致癌细胞在变形区内转移的概率增大。变形区附近及流体域内部对应黏度函数的主体部分,其中第1、2和4种黏度函数在该区域表现出较高的黏度值。在右叶中,凸出变形区的剪切速率对应黏度函数的主体部分,第1、2和4种黏度函数在此处的黏度高于其他两种黏度函数。凹陷变形区的剪切速率则处于线性区间,第2、5种黏度函数下黏度增长率较高。左右叶的涡流区剪切速率均对应黏度函数峰值附近(见图7)。
不同入口速度与黏度函数会对膈肌腹膜及肝脏表面的变形行为产生显著影响。本文整合了30组工况下固体变形的测量数据,结果表明:无论肝脏左叶、右叶或采用何种黏度函数,随着入口速度增大,腹腔积液对膈肌腹膜的冲击力增强,导致其最大凸出变形量均增加,而最大凹陷变形量均减小。其中,第2组黏度函数所对应的凸出变形量最大,凹陷变形量最小[见图8(a)、(b)]。对于肝脏表面,入口速度的提高部分抵消了重力的影响,使其沿重力方向的偏移量略有减小,但该变化幅度远小于膈肌腹膜的变形量[见图8(c)]。重力仍是影响肝脏表面变形的主要因素。
腹腔积液入口流速升高会削弱重力对膈肌腹膜及肝脏表面变形的作用。具体而言,膈肌腹膜的凸出变形量随之增大,凹陷变形量则减小;肝脏表面中心沿重力方向的偏移量也相应降低。入口速度不仅直接影响固体结构的变形,还通过改变流场的动态特性间接调控变形行为。流速升高改变了流场内剪切速率的分布,进而影响黏度分布,导致变形区局部黏度上升。这一变化提高了癌细胞在变形区壁面附近转移与种植的概率,其中以右叶出口附近的凹陷变形区最为显著。
腹腔积液的黏度对膈肌腹膜变形具有显著影响,而对肝脏表面变形的影响相对较小。具体而言,膈肌腹膜变形区的黏度越大,其凸出变形量越大,凹陷变形量则越小。在出入口分界线附近,黏度增大还会增强涡流效应。在左叶的凹陷与凸出变形区以及右叶的凹陷变形区,主要受黏度函数线性区间内黏度的影响。在第2、5种黏度函数下,癌细胞在这些区域转移和种植的概率较高。在右叶凸出变形区(即主流区),主要受黏度函数主体部分黏度的影响,其中第1、2种黏度函数下更易导致癌细胞在该区域发生转移和种植。而在涡流区及镰状韧带壁面附近,主要受黏度函数峰值附近黏度的影响。
本研究表明,肝脏结构为腹腔积液的流动模拟提供了重要的固定支撑作用,是保证模拟准确性的关键因素。腹腔积液的流动会引发膈肌腹膜与肝脏表面的变形,而这些变形又进一步改变流场形态,反过来影响积液自身的流动行为。作为典型的非牛顿流体,腹腔积液的速度分布与黏度之间存在双向耦合关系。本文通过双向流固耦合模拟,构建了速度场、黏度场与固体变形场之间的多场耦合模型,从而准确描述了腹腔积液的流动状态及其对肝脏和膈肌腹膜变形的影响。研究结果为识别癌细胞在腹腔内转移的潜在易感区域提供了定量依据,对进一步研究卵巢癌细胞在肝脏-腹膜内壁间腔内的运动机制及确定其主要转移区域具有重要理论意义。通过整合肿瘤生物学与生物流体力学方法,本研究也为后续个性化治疗策略的制定提供了重要参考,尤其在腹腔转移的早期识别与靶向干预方面展现出潜在的临床应用价值。
  • 辽宁省自然科学基金项目(2021-MS-277)
  • 辽宁省教育厅科学研究计划项目(LZ2020063)
  • 1+X临床技术水平提升项目(2022LCJSZD04; 2022LCJSGC23)
  • 1+X计划临床研究孵化项目(2020LCYJYB11)
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doi: 10.16156/j.1004-7220.2025.05.032
  • 接收时间:2025-01-09
  • 首发时间:2026-03-27
  • 出版时间:2025-10-01
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  • 收稿日期:2025-01-09
  • 修回日期:2025-02-21
基金
辽宁省自然科学基金项目(2021-MS-277)
辽宁省教育厅科学研究计划项目(LZ2020063)
1+X临床技术水平提升项目(2022LCJSZD04; 2022LCJSGC23)
1+X计划临床研究孵化项目(2020LCYJYB11)
作者信息
    1.大连理工大学 化工学院,辽宁 大连 1160241
    2.大连医科大学附属第二医院 妇科二科,辽宁 大连 116023

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武锦涛,副教授,E-mail:
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https://castjournals.cast.org.cn/joweb/yyswlx/CN/10.16156/j.1004-7220.2025.05.032
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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