Image-based patient-specific flow simulations are consistent with stroke in pediatric cerebrovascular disease.
Image-based patient-specific flow simulations are consistent with stroke in pediatric cerebrovascular disease.
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DOI：
10.1007/s10237-021-01495-9
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发表时间：
2021-12
影响因子：
3.5
通讯作者：
Annapragada A
中科院分区：
文献类型：
--
作者：
Hossain SS;Starosolski Z;Sanders T;Johnson MJ;Wu MCH;Hsu MC;Milewicz DM;Annapragada A
烟雾病（Moyamoya disease，MMD）是一种以颈内动脉远端和Willis环（Circle of Willis，CoW）狭窄为特征的疾病，可导致缺血性和出血性卒中的复发。对50例儿童MMD患者的数据进行回顾性分析，发现在24例单侧卒中并接受手术治疗的患者中，11例（45.8%）随后发生了对侧卒中。没有可靠的方法来预测这些事件。在对具有MMD特征的Acta−/−小鼠进行初步研究后，我们假设局部血流动力学可预测对侧卒中，并试图开发一种患者特异性分析框架来无创评估这种卒中风险。选择一例右侧大脑中动脉闭塞和右侧卒中的MMD患儿进行分析，该患儿接受了手术治疗，然后发生了对侧卒中。通过在等几何分析框架内使用非定常Navier-Stokes方程求解器，在从患者术后成像数据重建的CoW模型中模拟血流，并将结果与年龄和性别匹配的对照受试者的结果进行比较。在末端左侧床突上动脉中测量到壁剪切率（WSR）> 60，000 s-1（约为凝血阈值5000 s-1的12倍，为对照组的9倍）;其位置与随后的术后左侧卒中位置一致。疾病进展的参数研究显示，MMD改变的血管形态与局部血流动力学环境之间存在很强的相关性。结果表明，CoW中的闭塞可能导致对侧WSR过多，从而导致血栓栓塞性缺血事件，并且WSR可能是未来卒中的预测因子。
Moyamoya disease (MMD) is characterized by narrowing of the distal internal carotid artery and the circle of Willis (CoW) and leads to recurring ischemic and hemorrhagic stroke. A retrospective review of data from 50 pediatric MMD patients revealed that, among the 24 who had a unilateral stroke and were surgically treated, 11 (45.8%) had a subsequent, contralateral stroke. There is no reliable way to predict these events. After a pilot study in Acta−/− mice that have features of MMD, we hypothesized that local hemodynamics are predictive of contralateral strokes and sought to develop a patient-specific analysis framework to noninvasively assess this stroke risk. A pediatric MMD patient with an occlusion in the right middle cerebral artery and a right-sided stroke, who was surgically treated and then had a contralateral stroke, was selected for analysis. By using an unsteady Navier-Stokes solver within an isogeometric analysis framework, blood flow was simulated in the CoW model reconstructed from the patient’s postoperative imaging data, and the results were compared with those from an age- and sex-matched control subject. A wall shear rate (WSR) > 60,000 s−1 (about 12× higher than the coagulation threshold of 5000 s−1 and 9× higher than control) was measured in the terminal left supraclinoid artery; its location coincided with that of the subsequent postsurgical left-sided stroke. A parametric study of disease progression revealed a strong correlation between the degree of vascular morphology altered by MMD and local hemodynamic environment. The results suggest that an occlusion in the CoW could lead to excessive contralateral WSRs, resulting in thromboembolic ischemic events, and that WSR could be a predictor of future stroke.
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影响因子：
3.5
作者：
Hossain, Shaolie S.;Hughes, Thomas J. R.;Decuzzi, Paolo
通讯作者：
Decuzzi, Paolo
影响因子：
1.9
作者：
Seol, Ho Jun;Shin, Duk Chul;Wang, Kyu-Chang
通讯作者：
Wang, Kyu-Chang
影响因子：
2
作者：
Milewicz, Dianna M.;Ostergaard, John R.;Ala-Kokko, Leena M.;Khan, Nadia;Grange, Dorothy K.;Mendoza-Londono, Roberto;Bradley, Timothy J.;Olney, Ann Haskins;Ades, Lesley;Maher, Joseph F.;Guo, Dongchuan;Buja, L. Maximilian;Kim, Dong;Hyland, James C.;Regalado, Ellen S.
通讯作者：
Regalado, Ellen S.
DOI：
10.2217/nnm.12.124
发表时间：
2013-03
期刊：
Nanomedicine (London, England)
影响因子：
--
作者：
Hossain SS;Zhang Y;Liang X;Hussain F;Ferrari M;Hughes TJ;Decuzzi P
通讯作者：
Decuzzi P
影响因子：
8.3
作者：
Lee, Woo-Jin;Jeong, Seul-Ki;Jung, Keun-Hwa
通讯作者：
Jung, Keun-Hwa