Fabbri Dario, Long Quan, Das Saroj, Pinelli Michele
Brunel Institute for Bioengineering, Brunel University, Uxbridge, Middlesex , UB8 3PH, UK.
Biomech Model Mechanobiol. 2014 Apr;13(2):289-302. doi: 10.1007/s10237-014-0561-0. Epub 2014 Mar 2.
Ischaemic stroke is responsible for up to 80% of stroke cases. Prevention of the reoccurrence of ischaemic attack or stroke for patients who survived the first symptoms is the major treatment target. Accurate diagnosis of the emboli source for a specific infarction lesion is very important for a better treatment for the patient. However, due to the complex blood flow patterns in the cerebral arterial network, little is known so far of the embolic particle flow trajectory and its behaviour in such a complex flow field. The present study aims to study the trajectories of embolic particles released from carotid arteries and basilar artery in a cerebral arterial network and the influence of particle size, mass and release location to the particle distributions, by computational modelling. The cerebral arterial network model, which includes major arteries in the circle of Willis and several generations of branches from them, was generated from MRI images. Particles with diameters of 200, 500 and 800 μm and densities of 800, 1,030 and 1,300 kg/m(3) were released in the vessel's central and near-wall regions. A fully coupled scheme of particle and blood flow in a computational fluid dynamics software ANASYS CFX 13 was used in the simulations. The results show that heavy particles (density large than blood or a diameter larger than 500 μm) normally have small travel speeds in arteries; larger or lighter embolic particles are more likely to travel to large branches in cerebral arteries. In certain cases, all large particles go to the middle cerebral arteries; large particles with higher travel speeds in large arteries are likely to travel at more complex and tortuous trajectories; emboli raised from the basilar artery will only exit the model from branches of basilar artery and posterior cerebral arteries. A modified Circle of Willis configuration can have significant influence on particle distributions. The local branch patterns of internal carotid artery to middle cerebral artery and anterior communicating artery can have large impact on such distributions.
缺血性中风占中风病例的比例高达80%。对于首次发病后幸存的患者,预防缺血性发作或中风的复发是主要治疗目标。准确诊断特定梗死灶的栓子来源对于患者的更好治疗非常重要。然而,由于脑动脉网络中血流模式复杂,目前对于栓子颗粒在如此复杂流场中的流动轨迹及其行为知之甚少。本研究旨在通过计算建模研究脑动脉网络中从颈动脉和基底动脉释放的栓子颗粒的轨迹,以及颗粒大小、质量和释放位置对颗粒分布的影响。脑动脉网络模型由MRI图像生成,包括 Willis 环中的主要动脉及其几代分支。直径为200、500和800μm且密度为800、1030和1300 kg/m³的颗粒在血管中心和近壁区域释放。模拟中使用了计算流体动力学软件ANASYS CFX 13中颗粒与血流的完全耦合方案。结果表明,重颗粒(密度大于血液或直径大于500μm)在动脉中的行进速度通常较小;较大或较轻的栓子颗粒更有可能进入脑动脉的大分支。在某些情况下,所有大颗粒都进入大脑中动脉;在大动脉中行进速度较高的大颗粒可能以更复杂和曲折的轨迹行进;从基底动脉升起的栓子只会从基底动脉和大脑后动脉的分支处离开模型。Willis 环的改良构型会对颗粒分布产生显著影响。颈内动脉至大脑中动脉和前交通动脉的局部分支模式会对这种分布产生很大影响。