Department of Radiology, Academic Medical Center, University of Amsterdam, the Netherlands.
AJNR Am J Neuroradiol. 2012 Oct;33(9):1786-90. doi: 10.3174/ajnr.A3142. Epub 2012 May 10.
Local hemodynamic information may help to stratify rupture risk of cerebral aneurysms. Patient-specific modeling of cerebral hemodynamics requires accurate data on BFV in perianeurysmal arteries as boundary conditions for CFD. The aim was to compare the BFV measured with PC-MR imaging with that obtained by using intra-arterial Doppler sonography and to determine interpatient variation in intracranial BFV.
In 10 patients with unruptured intracranial aneurysms, BFV was measured in the cavernous ICA with PC-MR imaging in conscious patients before treatment, and measured by using an intra-arterial Doppler sonography wire when the patient was anesthetized with either propofol (6 patients) or sevoflurane (4 patients).
Both techniques identified a pulsatile blood flow pattern in cerebral arteries. PSV differed >50 cm/s between patients. A mean velocity of 41.3 cm/s (95% CI, 39.3-43.3) was measured with PC-MR imaging. With intra-arterial Doppler sonography, a mean velocity of 29.3 cm/s (95% CI, 25.8-32.8) was measured with the patient under propofol-based intravenous anesthesia. In patients under sevoflurane-based inhaled anesthesia, a mean velocity of 44.9 cm/s (95% CI, 40.6-49.3) was measured.
We showed large differences in BFV between patients, emphasizing the importance of using patient-specific hemodynamic boundary conditions in CFD. PC-MR imaging measurements of BFV in conscious patients were comparable with those obtained with the intra-arterial Doppler sonography when the patient was anesthetized with a sevoflurane-based inhaled anesthetic.
局部血流动力学信息可能有助于对脑动脉瘤破裂风险进行分层。脑血流动力学的患者特异性建模需要在 CFD 中作为边界条件使用peri-an eurysmal 动脉的准确 BFV 数据。本研究旨在比较 PC-MRI 成像测量的 BFV 与使用经动脉多普勒超声测量的 BFV,并确定颅内 BFV 的患者间变异性。
在 10 例未破裂颅内动脉瘤患者中,在清醒患者治疗前使用 PC-MRI 成像测量海绵窦 ICA 中的 BFV,并在患者接受异丙酚(6 例)或七氟醚(4 例)全身麻醉时使用经动脉多普勒超声线测量 BFV。
两种技术均在脑动脉中识别出脉动血流模式。PSV 在患者间相差>50cm/s。使用 PC-MRI 成像测量平均速度为 41.3cm/s(95%CI,39.3-43.3)。在接受基于异丙酚的静脉麻醉的患者中,经动脉多普勒超声测量平均速度为 29.3cm/s(95%CI,25.8-32.8)。在接受基于七氟醚的吸入麻醉的患者中,平均速度为 44.9cm/s(95%CI,40.6-49.3)。
我们发现患者间 BFV 存在很大差异,这强调了在 CFD 中使用患者特异性血流动力学边界条件的重要性。清醒患者的 PC-MRI 成像测量的 BFV 与患者接受基于七氟醚的吸入麻醉时使用经动脉多普勒超声测量的 BFV 相当。