Quantitative characterization of the hemodynamic environment in ruptured and unruptured brain aneurysms.
Quantitative characterization of the hemodynamic environment in ruptured and unruptured brain aneurysms.
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DOI：
10.3174/ajnr.a2419
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发表时间：
2011-01
期刊：
影响因子：
--
通讯作者：
Putman C
中科院分区：
文献类型：
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作者：
Cebral JR;Mut F;Weir J;Putman C
血流动力学被认为在动脉瘤的发病、进展和破裂机制中起重要作用。本研究的目的是定义与先前分析的定性血流特征相关的定量测量，并研究其与动脉瘤破裂的关系。应用基于图像的CFD技术对210例脑动脉瘤在不同流量条件下的血流动力学环境进行了分析。定量血流动力学变量的定义和提取的模拟结果。对与既往动脉瘤破裂史的关系进行了统计分析，并评估了血流条件的变异性。与未破裂的动脉瘤相比，破裂的动脉瘤更可能具有更大的流入浓度、更大的最大壁面剪切应力（WSS）、更大的剪切浓度和更低的粘性耗散率。破裂和未破裂动脉瘤的低WSS下的面积和异常低剪切力分布的测量值无统计学差异。虽然血流动力学量的值随不同的流动条件而变化，但对于脉动流和稳定流，破裂组和未破裂组的平均值之间的统计学差异或比值保持不变。集中的流入流和WSS分布以及最大WSS水平升高和低粘性耗散与既往动脉瘤破裂的临床病史在统计学上相关。相比之下，在WSS水平异常低的动脉瘤区域中施加的面积和总粘性剪切力不是。本研究强调了基于图像的CFD用于研究动脉瘤演变机制和动脉瘤风险临床评估的潜力。
Hemodynamics is thought to play an important role in the mechanisms of aneurysm pathogenesis, progression and rupture. The purpose of this study was to define quantitative measures related to qualitative flow characteristics previously analyzed and to investigate their relationship to aneurysm rupture. The hemodynamic environments in 210 cerebral aneurysms were analyzed using image-based CFD under different flow conditions. Quantitative hemodynamic variables were defined and extracted from the simulation results. A statistical analysis of the relationship to the previous history of aneurysm rupture was performed, and the variability with flow conditions was assessed. Ruptured aneurysms were more likely to have larger inflow concentrations, larger maximum wall shear stress (WSS), larger shear concentrations and lower viscous dissipation ratios than unruptured aneurysms. Areas under low WSS and measures of abnormally low shear force distributions of ruptured and unruptured aneurysms were not statistically different. Although the values of hemodynamic quantities changed with different flow conditions, the statistical differences or ratios between their mean values over the ruptured and unruptured groups were maintained, for both pulsatile and steady flows. Concentrated inflow streams and WSS distributions with elevated levels of maximal WSS and low aneurysmal viscous dissipation are statistically associated with a clinical history of prior aneurysm rupture. In contrast, the area and total viscous shear force applied in the aneurysm region subjected to abnormally low WSS levels are not. This study highlights the potential for image-based CFD for investigating aneurysm evolution mechanisms and for clinical assessment of aneurysm risks.