Hemodynamic characteristics of the vertebrobasilar system analyzed using MRI-based models.
Hemodynamic characteristics of the vertebrobasilar system analyzed using MRI-based models.
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DOI：
10.1371/journal.pone.0051346
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Gore JC
中科院分区：
文献类型：
--
作者：
Wake-Buck AK;Gatenby JC;Gore JC
椎基底动脉系统(VBS)在人体解剖学上是独一无二的，因为两条动脉汇合成一条血管，它特别重要，因为它供应大脑的后循环。动脉粥样硬化发生在这个区域，椎基底动脉汇合处的动脉粥样硬化斑块可以进展，导致灾难性的后果，包括动脉闭塞。对VBS内血流特征的定量评估可以阐明影响汇合处血流模式的因素，然后可以利用与正常模式的偏离来预测位置，监测潜在的病理变化，发现疾病的早期迹象，并评估治疗方案和疗效。在这项研究中，高场磁共振结合计算流体动力学模型来研究特定受试者融合模型(n = 5)的血流动力学，并识别健康成年受试者不同几何类型的椎基底动脉系统(n = 12)。血管的曲率和相互取向对VBS内的流动参数有显著影响。基底动脉几何形状对VBS的速度分布和壁切应力分布均有很大影响。所有5名受试者都具有不同程度的椎动脉不对称，其中4例观察到螺旋血流，这表明椎动脉血流混合的影响因素不是椎动脉不对称。这些初步研究证实，定量磁共振成像技术与健康成人受试者的特定CFD模型相结合，可以用来表征VBS的血流动力学，并预测与大动脉动脉粥样硬化的发生和发展有关的血流特征。这项工作代表了将这一方法应用于研究VBS中疾病的起始和发展的重要的第一步。
The vertebrobasilar system (VBS) is unique in human anatomy in that two arteries merge into a single vessel, and it is especially important because it supplies the posterior circulation of the brain. Atherosclerosis develops in this region, and atherosclerotic plaques in the vertebrobasilar confluence can progress with catastrophic consequences, including artery occlusion. Quantitative assessments of the flow characteristics in the VBS could elucidate the factors that influence flow patterns in this confluence, and deviations from normal patterns might then be used to predict locations to monitor for potential pathological changes, to detect early signs of disease, and to evaluate treatment options and efficacy. In this study, high-field MRI was used in conjunction with computational fluid dynamics (CFD) modeling to investigate the hemodynamics of subject-specific confluence models (n = 5) and to identify different geometrical classes of vertebrobasilar systems (n = 12) of healthy adult subjects. The curvature of the vessels and their mutual orientation significantly affected flow parameters in the VBS. The basilar artery geometry strongly influenced both skewing of the velocity profiles and the wall shear stress distributions in the VBS. All five subjects modeled possessed varying degrees of vertebral asymmetry, and helical flow was observed in four cases, suggesting that factors other than vertebral asymmetry influence mixing of the vertebral artery flow contributions. These preliminary studies verify that quantitative, MR imaging techniques in conjunction with subject-specific CFD models of healthy adult subjects may be used to characterize VBS hemodynamics and to predict flow features that have been related to the initiation and development of atherosclerosis in large arteries. This work represents an important first step towards applying this approach to study disease initiation and progression in the VBS.
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