Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Stroke. 2012 Jan;43(1):61-6. doi: 10.1161/STROKEAHA.111.626846. Epub 2011 Oct 13.
The hemodynamic factors of aneurysms were recently evaluated using computational fluid dynamics in a static vessel model in an effort to understand the mechanisms of initiation and rupture of aneurysms. However, few reports have evaluated the dynamic wall motion of aneurysms due to the cardiac cycle. The objective of this study was to quantify cardiac cycle-related volume changes in aneurysms using 4-dimensional CT angiography.
Four-dimensional CT angiography was performed in 18 patients. Image data of 1 cardiac cycle were divided into 10 phases and the volume of the aneurysm was then quantified in each phase. These data were also compared with intracranial vessels of normal appearance.
The observed cardiac cycle-related volume changes were in good agreement with the sizes of the aneurysms and normal vessels. The cardiac cycle-related volume changes of the intracranial aneurysms and intracranial normal arteries were 5.40%±4.17% and 4.20±2.04%, respectively, but these did not differ statistically (P=0.12).
We successfully quantified the volume change in intracranial aneurysms and intracranial normal arteries in human subjects. The data may indicate that cardiac cycle-related volume changes do not differ between unruptured aneurysms and normal intracranial arteries, suggesting that the global integrity of an unruptured aneurysmal wall is not different from that of normal intracranial arteries.
最近,人们使用计算流体动力学在静态血管模型中评估了动脉瘤的血流动力学因素,以试图了解动脉瘤破裂的发生机制。然而,由于心脏周期的原因,很少有报道评估动脉瘤的动态壁运动。本研究的目的是使用 4 维 CT 血管造影术来量化动脉瘤的心脏周期相关体积变化。
对 18 例患者进行了 4 维 CT 血管造影术。将 1 个心动周期的图像数据分为 10 个相位,然后在每个相位中量化动脉瘤的体积。这些数据还与外观正常的颅内血管进行了比较。
观察到的与心脏周期相关的体积变化与动脉瘤的大小和正常血管吻合良好。颅内动脉瘤和颅内正常动脉的心脏周期相关体积变化分别为 5.40%±4.17%和 4.20±2.04%,但统计学上无差异(P=0.12)。
我们成功地量化了人类颅内动脉瘤和颅内正常动脉的体积变化。这些数据可能表明,未破裂动脉瘤和正常颅内动脉之间的心脏周期相关体积变化没有差异,这表明未破裂动脉瘤壁的整体完整性与正常颅内动脉没有区别。