Computational Analysis of Cerebral Aneurysm Evolution

脑动脉瘤演化的计算分析

• 批准号: 7617027
• 负责人: Juan R Cebral
• 金额: $ 34.04万
• 依托单位: GEORGE MASON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7617027
• 关键词: Aneurysm; Angiography; Arts; Biomechanics; Blood Vessels; Brain Aneurysms; Brain hemorrhage; Bulla; Cerebral Aneurysm; Characteristics; Clinical; Clinical Management; Computer Analysis; Computer Simulation; Computer software; Data; Databases; Development; Diagnosis; Environment; Evaluation; Evolution; Exposure to; Goals; Growth; Image; Image Analysis; Individual; Injury; Interdisciplinary Study; Knowledge; Laser-Doppler Velocimetry; Liquid substance; Measures; Medical Imaging; Methodology; Modeling; Natural History; Patients; Pattern; Phase; Populations at Risk; Probability; Process; Prospective Studies; Relative (related person); Research Personnel; Resources; Rupture; Series; Stress; Subarachnoid Hemorrhage; System; Systems Analysis; Techniques; Technology; Testing; Time; Velocimetries; Work; X-Ray Computed Tomography; base; bone; computerized tools; experience; follow-up; hemodynamics; in vitro Model; longitudinal analysis; longitudinal database; outcome forecast; particle; prospective; shear stress; simulation; tool

Description (provided by the applicant): Cerebral aneurysm rupture is a leading cause of hemorrhagic strokes. Because unruptured cerebral aneurysms are being more frequently detected and the prognosis of subarachnoid hemorrhage is still poor, clinicians are often required to judge which aneurysms are prone to progression and rupture. Unfortunately our understanding of the natural history of cerebral aneurysms is limited because the processes of aneurysm initiation, growth and rupture are not well understood. Previous studies have identified the major factors involved in these processes: a) arterial hemodynamics, b) wall biomechanics and mechanobiology, and c) peri-aneurysmal environment (PAE). However, little is known about the relative importance of these factors, their interaction in an individual subject, or their variability across at-risk populations. The overall objective of this project is twofold: a) to gain a better understanding of the mechanisms responsible for the progression of cerebral aneurysms, and b) to develop an integrated system for cerebral aneurysm analysis. Our working hypothesis is that the growth pattern of cerebral aneurysms is determined by the distribution of focal wall damage related to exposure to concentrated hemodynamic wall shear stress and the mitigating effect of bone-aneurysm contact. The project will be divided into three basic phases. In Phase I (development), we will develop and integrate aneurysm modeling and characterization tools and database. The hemodynamics modeling suite will be validated with patient-specific in vitro models constructed using rapid prototyping technology and measured with particle image velocimetry and laser Doppler velocimetry. In Phase II (knowledge discovery), a series of growing and stable aneurysms will be selected from a unique longitudinal database of computed tomography angiography (CTA) images of unruptured aneurysms existing at UCLA, and modeled in order to identify hemodynamic and PAE characteristics and wall damage markers that best correlate with aneurysm growth. In Phase III (demonstration), we will conduct a prospective study of aneurysm evolution based on longitudinal CTA data of patients with unruptured cerebral aneurysms in order to evaluate the growth predictors identified in Phase II. The Specific Aims of the project are to: 1. Develop a system for cerebral aneurysm characterization 2. Study associations of hemodynamic and PAE characteristics to aneurysm growth 3. Evaluate growth predictors using prospective longitudinal data of unruptured aneurysms If our hypotheses are proven to be correct, and the methodology is successfully implemented, there will be a huge positive impact upon the clinical management of unruptured brain aneurysms.

描述（由申请方提供）：脑动脉瘤破裂是出血性卒中的主要原因。由于未破裂的脑动脉瘤越来越多地被发现，而蛛网膜下腔出血的预后仍然很差，临床医生经常需要判断哪些动脉瘤容易进展和破裂。不幸的是，我们对脑动脉瘤的自然史的理解是有限的，因为动脉瘤的发生，生长和破裂的过程没有很好地理解。先前的研究已经确定了这些过程中涉及的主要因素：a）动脉血流动力学，B）壁生物力学和机械生物学，以及c）血管周围环境（PAE）。然而，我们对这些因素的相对重要性、它们在个体受试者中的相互作用或它们在高危人群中的变异性知之甚少。该项目的总体目标有两个方面：a）更好地了解脑动脉瘤进展的机制，以及B）开发一个用于脑动脉瘤分析的集成系统。我们的工作假设是，脑动脉瘤的生长模式是由与暴露于集中的血流动力学壁剪切应力相关的局灶性壁损伤的分布和骨-动脉瘤接触的缓解作用决定的。该项目将分为三个基本阶段。在第一阶段（开发），我们将开发和集成动脉瘤建模和表征工具和数据库。血液动力学建模套件将通过使用快速原型技术构建的患者特定体外模型进行验证，并使用粒子图像测速仪和激光多普勒测速仪进行测量。在II期（知识发现）中，将从UCLA现有未破裂动脉瘤的计算机断层扫描血管造影（CTA）图像的独特纵向数据库中选择一系列生长和稳定的动脉瘤，并进行建模，以识别与动脉瘤生长最相关的血流动力学和PAE特征以及壁损伤标记物。在III期（演示）中，我们将基于未破裂脑动脉瘤患者的纵向CTA数据进行一项动脉瘤演变的前瞻性研究，以评价II期中确定的生长预测因子。该项目的具体目标是：1。开发脑动脉瘤表征系统2.研究血流动力学和PAE特征与动脉瘤生长的相关性3.使用未破裂动脉瘤的前瞻性纵向数据评估生长预测因子如果我们的假设被证明是正确的，并且该方法被成功实施，将对未破裂脑动脉瘤的临床管理产生巨大的积极影响。