Kim Tackeun, Bang Jae Seung, Kwon O-Ki, Hwang Gyojun, Kim Jeong Eun, Kang Hyun-Seung, Cho Won Sang, Moon Jong Un, Oh Chang Wan
Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea.
Acta Neurochir (Wien). 2015 May;157(5):755-61. doi: 10.1007/s00701-015-2367-y. Epub 2015 Feb 18.
Morphological studies investigating the intracranial-extradural internal carotid artery with moyamoya disease have not been reported. We designed this case-control study to investigate the morphological differences of the internal carotid artery with moyamoya disease, and to clarify the contributions of these differences to the resultant fluid dynamics.
Patients with moyamoya disease and normal controls were assigned to each group. The vascular tortuosity of internal carotid artery was measured with three-dimensional rendering using magnetic resonance angiography. By computational fluid dynamics, hemodynamic characteristics were simulated and compared between two groups.
Distances were measured from the carotid canal to the siphon. A shorter actual distance was observed in the moyamoya group (p = 0.0170). Vascular tortuosity was significantly low in moyamoya patients showing lower curvature angles in the petrous and intra-cavernous segments (p = 0.0012). Less blood flowed (p < 0.0001) through the narrower internal carotid artery (p < 0.0001) in the moyamoya group at the carotid canal level. The blood flow velocities were not significantly different (p = 0.2332). Faster blood flow and higher wall shear stress in the internal carotid artery bifurcation were verified with computational fluid dynamics.
Significant morphological differences were confirmed to exist in the intracranial-extradural internal carotid artery of moyamoya patients. These differences might influence the hemodynamics around the bifurcation of the internal carotid artery.
尚未见关于烟雾病患者颅内-硬膜外颈内动脉形态学研究的报道。我们设计了这项病例对照研究，以探讨烟雾病患者颈内动脉的形态学差异，并阐明这些差异对血流动力学的影响。
将烟雾病患者和正常对照者分为两组。使用磁共振血管造影通过三维重建测量颈内动脉的血管迂曲度。通过计算流体动力学模拟并比较两组的血流动力学特征。
测量了从颈动脉管到虹吸部的距离。烟雾病组观察到实际距离较短（p = 0.0170）。烟雾病患者的血管迂曲度显著降低，在岩骨段和海绵窦段显示出较小的弯曲角度（p = 0.0012）。在颈动脉管水平，烟雾病组通过较窄的颈内动脉的血流量较少（p < 0.0001）（p < 0.0001）。血流速度无显著差异（p = 0.2332）。通过计算流体动力学证实了颈内动脉分叉处血流更快且壁面剪应力更高。
证实烟雾病患者颅内-硬膜外颈内动脉存在显著的形态学差异。这些差异可能会影响颈内动脉分叉处周围的血流动力学。
