Exploring the efficacy of endoscopic ventriculostomy for hydrocephalus treatment via a multicompartmental poroelastic model of CSF transport: a computational perspective.
Exploring the efficacy of endoscopic ventriculostomy for hydrocephalus treatment via a multicompartmental poroelastic model of CSF transport: a computational perspective.
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DOI：
10.1371/journal.pone.0084577
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Ventikos Y
中科院分区：
文献类型：
--
作者：
Vardakis JC;Tully BJ;Ventikos Y
本研究提出了一个多网络孔隙弹性理论（MPET）模型与有限体积计算流体动力学相结合，以详细研究在解剖学精确的大脑环境中阻碍脑脊液运输的影响。MPET表现可以全面、全面地研究脑脊液、脑实质和脑血之间的液体输送。该模型的一个关键新颖之处在于解剖学上精确的脉络膜丛与其供血动脉的融合，以及一种简单的关系，放松了脑脊液室独特通透性的限制。这样做是为了解释水通道蛋白-4介导的肿胀特征。这种不同渗透性的隔室的目的是揭示一种反馈机制，该机制可以通过过量的脑脊液外排进入血液系统来抵消心室扩张和随后脑脊液压力升高的影响。该模型用于验证输水管狭窄和第四脑室出口梗阻（FVOO）的影响。本文考虑了内镜下第三（ETV）和内镜下第四（EFV）脑室切开术治疗这种临床疾病的意义。正常人脑脊液流速峰值为15.6 cm/s，轻度和重度脑脊液流速峰值分别为45.4 cm/s和72.8 cm/s。ETV的应用将渡槽速度降低到16-17 cm/s左右。心室位移、脑脊液压力、壁剪切应力（WSS）以及侧脑室和第四脑室之间的压力差（ΔP）随着狭窄的应用而增加，随后随着ETV的应用而下降到名义水平。闭锁效果的最大逆转来自于选择ETV而不是更复杂的EFV手术。
This study proposes the implementation of a Multiple-Network Poroelastic Theory (MPET) model coupled with finite-volume computational fluid dynamics for the purpose of studying, in detail, the effects of obstructing CSF transport within an anatomically accurate cerebral environment. The MPET representation allows the investigation of fluid transport between CSF, brain parenchyma and cerebral blood, in an integral and comprehensive manner. A key novelty in the model is the amalgamation of anatomically accurate choroid plexuses with their feeding arteries and a simple relationship relaxing the constraint of a unique permeability for the CSF compartment. This was done in order to account for the Aquaporin-4-mediated swelling characteristics. The aim of this varying permeability compartment was to bring to light a feedback mechanism that could counteract the effects of ventricular dilation and subsequent elevations of CSF pressure through the efflux of excess CSF into the blood system. This model is used to demonstrate the impact of aqueductal stenosis and fourth ventricle outlet obstruction (FVOO). The implications of treating such a clinical condition with the aid of endoscopic third (ETV) and endoscopic fourth (EFV) ventriculostomy are considered. We observed peak CSF velocities in the aqueduct of the order of 15.6 cm/s in the healthy case, 45.4 cm/s and 72.8 cm/s for the mild and severe cases respectively. The application of ETV reduced the aqueductal velocity to levels around 16–17 cm/s. Ventricular displacement, CSF pressure, wall shear stress (WSS) and pressure difference between lateral and fourth ventricles (ΔP) increased with applied stenosis, and subsequently dropped to nominal levels with the application of ETV. The greatest reversal of the effects of atresia come by opting for ETV rather than the more complicated procedure of EFV.
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影响因子：
4.1
作者：
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通讯作者：
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影响因子：
5.3
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影响因子：
3.3
作者：
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通讯作者：
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