Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
AJNR Am J Neuroradiol. 2013 Nov-Dec;34(11):2187-91. doi: 10.3174/ajnr.A3575. Epub 2013 Jun 6.
Posterior communicating artery aneurysms with oculomotor nerve palsy may imply sudden enlargement of the aneurysm sac and have a high risk of rupture. Our aim was to identify the morphologic and hemodynamic parameters in this special period of aneurysm progression and to assess related rupture risk indices.
We analyzed the morphologic and hemodynamic parameters of 9 unruptured posterior communicating artery aneurysms with oculomotor nerve palsy and 9 ruptured ones. The morphologic parameters were measured and calculated from patient-specific 3D rotational angiographic images, and pulsatile computational fluid dynamic simulation was then performed for hemodynamic parameters.
There was no significant statistical difference between the 2 groups in size, aspect ratio, size ratio, aneurysm angle, or vessel angle; analysis only demonstrated a significantly lower wall shear stress of the aneurysm wall in the symptomatic unruptured group in hemodynamics (P = .024), whereas there were no differences in wall shear stress of the parent artery, low wall shear stress area, and oscillatory shear index.
From morphologic and hemodynamic perspectives, we demonstrated that posterior communicating artery aneurysms with oculomotor nerve palsy had characteristics similar to those of ruptured ones, except for lower wall shear stress on the aneurysm wall, which might indicate an important role in aneurysm rupture.
伴有动眼神经麻痹的后交通动脉动脉瘤可能意味着动脉瘤囊突然增大，破裂风险很高。我们的目的是确定在这个特殊的动脉瘤进展阶段的形态学和血流动力学参数，并评估相关的破裂风险指数。
我们分析了 9 个未破裂伴有动眼神经麻痹的后交通动脉动脉瘤和 9 个破裂的后交通动脉动脉瘤的形态学和血流动力学参数。形态学参数是从患者特定的 3D 旋转血管造影图像中测量和计算的，然后对血流动力学参数进行脉动计算流体动力学模拟。
在大小、长宽比、大小比、动脉瘤角度和血管角度方面，两组之间没有显著的统计学差异；分析仅显示在血流动力学方面，症状性未破裂组的动脉瘤壁壁切应力显著较低（P=.024），而在母体动脉壁切应力、低壁切应力区和振荡剪切指数方面没有差异。
从形态学和血流动力学的角度来看，我们发现伴有动眼神经麻痹的后交通动脉动脉瘤除了动脉瘤壁的壁切应力较低外，与破裂的动脉瘤具有相似的特征，这可能表明其在动脉瘤破裂中起重要作用。
