颅内动脉瘤瘤泡形成的计算流体动力学分析。
Computational fluid dynamic analysis of intracranial aneurysmal bleb formation.
机构信息
*Kenneth Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Australia; ‡Department of Information Technology Services (High Performance Computing), §School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, Australia; ¶School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, Australia.
出版信息
Neurosurgery. 2013 Dec;73(6):1061-8; discussion 1068-9. doi: 10.1227/NEU.0000000000000137.
BACKGROUND
The management of unruptured aneurysms is controversial, with the decision to treat influenced by aneurysm characteristics including size and morphology. Aneurysmal bleb formation is thought to be associated with an increased risk of rupture.
OBJECTIVE
To correlate computational fluid dynamic (CFD) indices with bleb formation.
METHODS
Anatomic models were constructed from 3-dimensional rotational angiography data in 27 patients with cerebral aneurysms harboring a single bleb. Additional models representing the aneurysm before bleb formation were constructed by digitally removing the bleb. We characterized hemodynamic features of models both with and without the blebs using CFDs. Flow structure, wall shear stress (WSS), pressure, and oscillatory shear index (OSI) were analyzed.
RESULTS
There was a statistically significant association between bleb location at or adjacent to the point of maximal WSS (74%, P = .019), irrespective of rupture status. Aneurysmal blebs were related to the inflow or outflow jet in 89% of cases (P < .001), whereas 11% were unrelated. Maximal wall pressure and OSI were not significantly related to bleb location. The bleb region attained a lower WSS after its formation in 96% of cases (P < .001) and was also lower than the average aneurysm WSS in 86% of cases (P < .001).
CONCLUSION
Cerebral aneurysm blebs generally form at or adjacent to the point of maximal WSS and are aligned with major flow structures. Wall pressure and OSI do not contribute to determining bleb location. The measurement of WSS using CFD models may potentially predict bleb formation and thus improve the assessment of rupture risk in unruptured aneurysms.
背景
未破裂动脉瘤的处理存在争议，治疗决策受到包括大小和形态在内的动脉瘤特征的影响。囊泡形成被认为与破裂风险增加有关。
目的
将计算流体动力学（CFD）指数与囊泡形成相关联。
方法
从 27 例存在单个囊泡的脑动脉瘤患者的三维旋转血管造影数据中构建解剖模型。通过数字方式去除囊泡，构建了代表囊泡形成之前的动脉瘤的附加模型。我们使用 CFDs 对有囊泡和无囊泡的模型进行了血流动力学特征的描述。分析了流型结构、壁面剪切应力（WSS）、压力和振荡剪切指数（OSI）。
结果
在最大 WSS 处或紧邻最大 WSS 处存在囊泡位置与破裂状态无关的统计学显著相关性（74%，P =.019）。在 89%的情况下（P <.001），动脉瘤囊泡与流入或流出射流有关，而在 11%的情况下（P <.001），囊泡与流入或流出射流无关。最大壁压和 OSI 与囊泡位置无显著相关性。在 96%的情况下（P <.001），囊泡形成后囊泡区域的 WSS 降低，并且在 86%的情况下（P <.001），囊泡区域的 WSS 也低于平均动脉瘤 WSS。
结论
脑动脉瘤囊泡通常在最大 WSS 处或紧邻最大 WSS 处形成，并且与主要流动结构对齐。壁压和 OSI 对确定囊泡位置没有贡献。使用 CFD 模型测量 WSS 可能有助于预测囊泡形成，从而提高对未破裂动脉瘤破裂风险的评估。
Zotero 插件