Correlation between lumenal geometry changes and hemodynamics in fusiform intracranial aneurysms.
Correlation between lumenal geometry changes and hemodynamics in fusiform intracranial aneurysms.
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发表时间：
2005-10
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通讯作者：
L. Jou;G. Wong;B. Dispensa;M. Lawton;R. Higashida;W. Young;D. Saloner
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作者：
L. Jou;G. Wong;B. Dispensa;M. Lawton;R. Higashida;W. Young;D. Saloner
背景和目的血流动力学可能导致动脉瘤破裂；然而，可以描述动脉瘤生长的血流动力学描述符尚不清楚。我们检查了血流动力学与 2 个梭形基底动脉瘤生长之间的关系，试图定义可能有助于预测动脉瘤生长的血流动力学变量。方法 对两名患有相似大小的基底梭形动脉瘤的患者进行为期 2 年的随访。分别使用 MR 血管造影和测速法获得管腔几何形状以及流入和流出速率。通过配准不同时间获得的动脉瘤模型来确定动脉瘤生长的位置。通过使用计算流体动力学模拟计算血流动力学描述符，并与动脉瘤生长模式进行比较。结果 一名患者的动脉瘤显着增大，但另一名患者的相似大小的动脉瘤保持不变。最大的动脉瘤生长（约3毫米/年）出现在动脉瘤的下侧（下部），那里的壁剪切应力非常低（<0.1N/m(2)）。即使在生长的动脉瘤中，总体血流模式也不会随时间改变，但这两名患者的壁剪切应力直方图却截然不同。结论 本研究调查了血流动力学描述符是否可以根据患者具体情况与动脉瘤管腔形态的区域变化相关。这种能力将允许在纵向研究中测试关于哪些机制在动脉瘤生长中最重要的假设。
BACKGROUND AND PURPOSE Hemodynamics may predispose aneurysms to rupture; however, hemodynamic descriptors that can describe aneurysm growth are not well understood. We examined the relationship between hemodynamics and growth of 2 fusiform basilar artery aneurysms in an effort to define hemodynamic variables that may be helpful in predicting aneurysmal growth. METHODS Two patients with basilar fusiform aneurysms of a similar size were followed for a 2-year period. The lumenal geometry and inflow and outflow rates were acquired by using MR angiography and velocimetry, respectively. The location of aneurysmal growth was identified by coregistering aneurysm models that were acquired at different times. Hemodynamic descriptors were calculated by using computational fluid dynamic simulations and compared with aneurysm growth pattern. RESULTS One patient had an aneurysm that grew significantly, but a similar-sized aneurysm in the other patient remained unchanged. The largest aneurysmal growth (approximately 3 mm/year) was found at the inferior side (lower part) of the aneurysm, where the wall shear stress was very low (<0.1N/m(2)). The general flow patterns did not change with time, even in the aneurysm that grew, but histograms of wall shear stress were very different in these 2 patients. CONCLUSIONS This study investigates whether hemodynamic descriptors can be correlated with regional changes in aneurysm lumen morphology on a patient-specific basis. That capability will permit the testing, in longitudinal studies, of hypotheses as to which mechanisms are the most important in aneurysm growth.