Castro M A, Putman C M, Cebral J R
School of Computational Sciences, George Mason University, Fairfax, VA 22042, USA.
AJNR Am J Neuroradiol. 2006 Sep;27(8):1703-9.
The purpose of this study is to show the influence of the upstream parent artery geometry on intraaneurysmal hemodynamics of cerebral aneurysms.
Patient-specific models of 4 cerebral aneurysms (1 posterior communicating artery [PcomA], 2 middle cerebral artery [MCA], and 1 anterior communicating artery [AcomA]) were constructed from 3D rotational angiography images. Two geometric models were constructed for each aneurysm. One model had the native parent vessel geometry; the second model was truncated approximately 1 cm upstream from the aneurysm, and the parent artery replaced with a straight cylinder. Corresponding finite element grids were generated and computational fluid dynamics simulations were carried out under pulsatile flow conditions. The intra-aneurysmal flow patterns and wall shear stress (WSS) distributions were visualized and compared.
Models using the truncated parent vessel underestimated the WSS in the aneurysms in all cases and shifted the impaction zone to the neck compared with the native geometry. These effects were more pronounced in the PcomA and AcomA aneurysms where upstream curvature was substantial. The MCA aneurysm with a long M1 segment was the least effected. The more laminar flow pattern within the parent vessel in truncated models resulted in a less complex intra-aneurysmal flow patterns with fewer vortices and less velocity at the dome.
Failure to properly model the inflow stream contributed by the upstream parent artery can significantly influence the results of intra-aneurysmal hemodynamic models. The upstream portion of the parent vessel of cerebral aneurysms should be included to accurately represent the intra-aneurysmal hemodynamics.
本研究旨在展示上游母动脉几何形状对脑动脉瘤瘤内血流动力学的影响。
从三维旋转血管造影图像构建4个脑动脉瘤(1个后交通动脉[PcomA]、2个大脑中动脉[MCA]和1个前交通动脉[AcomA])的患者特异性模型。每个动脉瘤构建两个几何模型。一个模型具有天然母血管几何形状;第二个模型在动脉瘤上游约1 cm处截断,并用直圆柱体代替母动脉。生成相应的有限元网格,并在脉动流条件下进行计算流体动力学模拟。对瘤内血流模式和壁面切应力(WSS)分布进行可视化并比较。
在所有情况下,使用截断母血管的模型低估了动脉瘤内的WSS,并与天然几何形状相比将撞击区转移至瘤颈。这些影响在PcomA和AcomA动脉瘤中更为明显,其上游曲率较大。具有长M1段的MCA动脉瘤受影响最小。截断模型中母血管内更呈层流的血流模式导致瘤内血流模式不太复杂,涡流较少且瘤顶处速度较低。
未能正确模拟上游母动脉贡献的流入血流会显著影响瘤内血流动力学模型的结果。应包括脑动脉瘤母血管的上游部分以准确呈现瘤内血流动力学。