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低壁切应力与大脑中动脉动脉瘤的破裂状态独立相关。

Low wall shear stress is independently associated with the rupture status of middle cerebral artery aneurysms.

机构信息

Department of Neurosurgery, Mie Chuo Medical Center, National Hospital Organization, 2158-5 Hisai-Myojin Cho, Tsu City, Mie 514-1101, Japan.

出版信息

Stroke. 2013 Feb;44(2):519-21. doi: 10.1161/STROKEAHA.112.675306. Epub 2012 Dec 6.

Abstract

BACKGROUND AND PURPOSE

We determined which hemodynamic parameter independently characterizes the rupture status of middle cerebral artery (MCA) aneurysms using computational fluid dynamics analysis.

METHODS

In 106 patient-specific geometries of MCA aneurysms (43 ruptured, 63 unruptured), morphological and hemodynamic parameters were compared between the ruptured and unruptured groups. Multivariate logistic regression analysis was performed to determine parameters that independently characterized the rupture status of MCA aneurysms.

RESULTS

Univariate analyses showed that the aspect ratio, wall shear stress (WSS), normalized WSS, oscillatory shear index, WSS gradient, and aneurysm-formation index were significant parameters. The size of the aneurysmal dome and the gradient oscillatory number were not significantly different between the 2 groups. With multivariate analyses, only lower WSS was significantly associated with the rupture status of MCA aneurysms.

CONCLUSIONS

WSS may be the most reliable parameter characterizing the rupture status of MCA aneurysms.

摘要

背景与目的

我们通过计算流体动力学分析,确定了哪些血流动力学参数可以独立描述大脑中动脉(MCA)动脉瘤的破裂状态。

方法

在 106 例 MCA 动脉瘤的患者特定几何形状中(43 例破裂,63 例未破裂),对破裂组和未破裂组之间的形态和血流动力学参数进行了比较。采用多变量逻辑回归分析确定可独立描述 MCA 动脉瘤破裂状态的参数。

结果

单因素分析表明,形态比、壁切应力(WSS)、标准化 WSS、振荡剪切指数、WSS 梯度和动脉瘤形成指数是显著参数。动脉瘤瘤顶的大小和振荡梯度数在两组之间无显著差异。多变量分析表明,只有较低的 WSS 与 MCA 动脉瘤的破裂状态显著相关。

结论

WSS 可能是描述 MCA 动脉瘤破裂状态的最可靠参数。

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