Hemodynamic findings associated with intraoperative appearances of intracranial aneurysms
Hemodynamic findings associated with intraoperative appearances of intracranial aneurysms
复制标题
与颅内动脉瘤术中出现相关的血流动力学结果(doi: 10.1007/s10143-018-1027-0)
DOI：
10.1007/s10143-018-1027-0
复制
发表时间：
2020-02-01
影响因子：
2.8
通讯作者：
Wang, Shuo
中科院分区：
文献类型：
--
作者：
Jiang, Pengjun;Liu, Qingyuan;Wang, Shuo
颅内动脉瘤根据术中表现可分为厚壁动脉瘤和薄壁动脉瘤;既往文献显示，不同的术中表现与术中破裂和术后并发症有关。在这里，我们试图使用计算流体动力学（CFD）方法来评估血流动力学特征和动脉瘤壁外观之间的关联。我们的研究包括41例连续的未破裂大脑中动脉（MCA）分叉部动脉瘤患者。根据显微镜下观察到的形态，将动脉瘤分为厚壁和薄壁两种不同类型。术前CT血管造影（CTA）用于几何重建和CFD分析。比较两组的形态学和血流动力学参数。根据术中表现，18例动脉瘤被归类为厚壁动脉粥样硬化动脉瘤。与薄壁动脉瘤相比，动脉粥样硬化改变的动脉瘤具有更大的几何参数（动脉瘤深度、最大高度、直径、长宽比、尺寸比）、更低的壁剪切应力（WSS）和更大的低WSS面积比（LSAR）。以动脉粥样硬化改变为特征的厚壁动脉瘤与低WSS和较大LSAR相关。CFD可能是鉴别脑动脉瘤术中表现的有用工具。
Intracranial aneurysms can be classified into thick-walled aneurysms and thin-walled aneurysms according to their intraoperative appearances; previous publications have revealed that different kinds of intraoperative appearances were associated with intraoperative rupture and postoperative complications. Here, we tried to evaluate the association between hemodynamic features and aneurysm wall appearance using computational fluid dynamics (CFD) method. Forty-one consecutive patients with unruptured middle cerebral artery (MCA) bifurcation aneurysms were included in our study. Based on the appearances observed under the microscope, aneurysms were classified into two different types: thick-walled and thin-walled aneurysms. Preoperative computed tomographic angiography (CTA) was used for geometry reconstruction and CFD analysis. Morphological and hemodynamic parameters were compared between the two groups. Eighteen aneurysms were classified as thick-walled atherosclerotic ones according to their intraoperative appearances. Compared with thin-walled aneurysms, aneurysms with atherosclerotic changes had larger geometry parameters (aneurysm depth, maximum height, diameter, aspect ratio, size ratio), lower wall shear stress (WSS), and larger low WSS area ratio (LSAR). Thick-walled aneurysms characterized by atherosclerotic changes are associated with low WSS and larger LSAR. CFD may be a useful tool for discriminating the intraoperative appearance of cerebral aneurysms.