Hydrodynamic and longitudinal impedance analysis of cerebrospinal fluid dynamics at the craniovertebral junction in type I Chiari malformation.
Hydrodynamic and longitudinal impedance analysis of cerebrospinal fluid dynamics at the craniovertebral junction in type I Chiari malformation.
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DOI：
10.1371/journal.pone.0075335
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Loth F
中科院分区：
文献类型：
--
作者：
Martin BA;Kalata W;Shaffer N;Fischer P;Luciano M;Loth F
颅颈交界处（CVJ）脑脊液（CSF）流速升高或降低与I型基亚里畸形（CMI）相关。因此，描述CSF动力学的流体动力学参数的量化可以帮助评估疾病的严重程度和手术结果。在这项研究中，我们描述的方法来量化CVJ和上颈椎附近的CSF流体动力学参数，利用受试者特定的计算流体动力学（CFD）模拟的基础上，在体内MRI测量的流量和几何形状。计算一名健康受试者和两名CMI患者减压手术前后的流体动力学参数，以确定病例之间的差异。我们第一次提出了量化纵向阻抗（LI）到CSF运动的方法，这是一个特定于受试者的流体动力学参数，可能有助于量化CMI中CSF流动阻塞的严重程度。此外，对每种情况下的以下流体动力学参数进行定量：收缩期和舒张期的最大速度、雷诺数和沃默斯利数以及CSF心脏血流周期期间的峰值压降。量化了以下几何参数：脊髓蛛网膜下腔（SAS）的横截面积和水力直径。CMI模型的几何参数的平均值在手术后增加，但仍小于健康志愿者。所有的流体动力学参数，除了压降，降低手术后的CMI患者，但仍然大于健康的情况下。峰值压降的变化是混合的。据我们所知，本研究代表了CMI减压手术的第一个特定受试者CFD模拟和CSF空间中LI的定量。需要在更大的患者和对照组中进行进一步研究，以确定所提供的几何和/或流体动力学参数是否有助于手术计划。
Elevated or reduced velocity of cerebrospinal fluid (CSF) at the craniovertebral junction (CVJ) has been associated with type I Chiari malformation (CMI). Thus, quantification of hydrodynamic parameters that describe the CSF dynamics could help assess disease severity and surgical outcome. In this study, we describe the methodology to quantify CSF hydrodynamic parameters near the CVJ and upper cervical spine utilizing subject-specific computational fluid dynamics (CFD) simulations based on in vivo MRI measurements of flow and geometry. Hydrodynamic parameters were computed for a healthy subject and two CMI patients both pre- and post-decompression surgery to determine the differences between cases. For the first time, we present the methods to quantify longitudinal impedance (LI) to CSF motion, a subject-specific hydrodynamic parameter that may have value to help quantify the CSF flow blockage severity in CMI. In addition, the following hydrodynamic parameters were quantified for each case: maximum velocity in systole and diastole, Reynolds and Womersley number, and peak pressure drop during the CSF cardiac flow cycle. The following geometric parameters were quantified: cross-sectional area and hydraulic diameter of the spinal subarachnoid space (SAS). The mean values of the geometric parameters increased post-surgically for the CMI models, but remained smaller than the healthy volunteer. All hydrodynamic parameters, except pressure drop, decreased post-surgically for the CMI patients, but remained greater than in the healthy case. Peak pressure drop alterations were mixed. To our knowledge this study represents the first subject-specific CFD simulation of CMI decompression surgery and quantification of LI in the CSF space. Further study in a larger patient and control group is needed to determine if the presented geometric and/or hydrodynamic parameters are helpful for surgical planning.
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影响因子：
4.1
作者：
Alperin, N;Sivaramakrishnan, A;Lichtor, T
通讯作者：
Lichtor, T
影响因子：
3.5
作者：
Linge, S. O.;Haughton, V.;Langtangen, H. P.
通讯作者：
Langtangen, H. P.
影响因子：
4.3
作者：
Schwartz, LB;Belkin, M;Whittemore, AD
通讯作者：
Whittemore, AD
影响因子：
1.9
作者：
Shaffer, Nicholas;Martin, Bryn;Loth, Francis
通讯作者：
Loth, Francis
影响因子：
2.4
作者：
BORGESEN, SE;ALBECK, MJ;LANIEWSKI, P
通讯作者：
LANIEWSKI, P