From the Departments of Radiology and Nuclear Medicine (B.M.W.C., J.J.S., M.E.S., R.v.d.B., P.v.O., A.J.N., H.A.M., C.B.L.M.M.)
Biomedical Engineering and Physics (B.M.W.C., E.v.B., H.A.M.).
AJNR Am J Neuroradiol. 2018 May;39(5):910-915. doi: 10.3174/ajnr.A5602. Epub 2018 Mar 29.
Hemodynamics are thought to play a role in intracranial aneurysm growth and rupture. Computational fluid dynamics is frequently performed to assess intra-aneurysmal hemodynamics, using generalized flow waveforms of healthy volunteers as inflow boundary conditions. The purpose of this study was to assess differences in inflow conditions for different aneurysmal parent artery locations and variations of circle of Willis configurations.
In a series of 96 patients with 103 aneurysms, velocity measurements were acquired using 2D phase-contrast MR imaging perpendicular to the aneurysmal parent arteries in the circle of Willis. Circle of Willis configurations were inspected for variations using multiple overlapping thin-slab-acquisition MRAs. Flow rates, velocity magnitudes, and pulsatility indices were calculated for each parent artery location in subgroups of complete and incomplete circle of Willis configurations.
Flow rates, velocity magnitudes, and pulsatility indices were significantly different among aneurysmal parent arteries. Incomplete circle of Willis configurations were observed in 24% of the cases. Significantly lower basilar artery flow rates were observed in configurations with hypoplastic P1 segments. Significantly higher A1 flow rates were observed in configurations with a hypoplastic contralateral A1 segment.
Inflow conditions vary substantially between aneurysmal parent arteries and circle of Willis configurations. We have created a collection of parent artery-specific inflow conditions tailored to the patient-specific circle of Willis configuration that can be used in future computational fluid dynamics studies analyzing intra-aneurysmal hemodynamics.
血流动力学被认为在颅内动脉瘤的生长和破裂中起作用。通常使用健康志愿者的通用血流波形作为流入边界条件来进行计算流体动力学,以评估颅内动脉瘤内的血流动力学。本研究的目的是评估不同的动脉瘤母动脉位置和Willis 环血管构型变化的流入条件差异。
在一系列 96 例 103 个动脉瘤患者中,使用垂直于 Willis 环中动脉瘤母动脉的二维相位对比 MR 成像获取速度测量值。使用多个重叠的薄层采集 MRA 检查 Willis 环血管构型的变化。在完整和不完整 Willis 环构型亚组中计算每个母动脉位置的流量、速度幅度和脉动指数。
动脉瘤母动脉之间的流量、速度幅度和脉动指数存在显著差异。在 24%的病例中观察到不完整的 Willis 环构型。在 P1 段发育不良的构型中观察到基底动脉流量显著降低。在对侧 A1 段发育不良的构型中观察到 A1 流量显著升高。
流入条件在动脉瘤母动脉和 Willis 环构型之间存在很大差异。我们创建了一组针对特定患者 Willis 环构型的特定母动脉流入条件,可用于未来分析颅内动脉瘤内血流动力学的计算流体动力学研究。