使用计算流体动力学对未破裂大脑中动脉动脉瘤的显微识别薄壁区的血流动力学特征进行研究。
Hemodynamic Features of Microsurgically Identified, Thin-Walled Regions of Unruptured Middle Cerebral Artery Aneurysms Characterized Using Computational Fluid Dynamics.
机构信息
Department of Neurosurgery, Armed Forces Capital Hospital, Gyeonggi-do, Republic of Korea.
Department of Neurosurgery, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
出版信息
Neurosurgery. 2020 Jun 1;86(6):851-859. doi: 10.1093/neuros/nyz311.
BACKGROUND
Thin-walled regions (TWRs) of aneurysm surfaces observed in microscopic surgery are thought to be vulnerable areas for growth and rupture of unruptured intracranial aneurysms (UIAs).
OBJECTIVE
To identify hemodynamic features of TWRs of aneurysms by using computational fluid dynamics (CFD) analyses of unruptured middle cerebral artery bifurcation (MCAB) aneurysms.
METHODS
Nine patients with 11 MCAB aneurysms were enrolled, and their TWRs were identified. CFD analysis was performed using 3 parameters: pressure, wall shear stress (WSS), and WSS divergence (WSSD). Each parameter was evaluated for its correspondence with TWR.
RESULTS
Among 11 aneurysms, 15 TWRs were identified. Corresponding matches with CFD parameters (pressure, WSS, and WSSD) were 73.33, 46.67, and 86.67%, respectively.
CONCLUSION
WSSD, a hemodynamic parameter that accounts for both magnitude and directionality of WSS, showed the highest correspondence. High WSSD might correspond with TWR of intracranial aneurysms, which are likely high-risk areas for rupture.
背景
在显微手术中观察到的动脉瘤表面薄壁区域（TWR）被认为是未破裂颅内动脉瘤（UIA）生长和破裂的脆弱区域。
目的
通过对未破裂大脑中动脉分叉（MCAB）动脉瘤的计算流体动力学（CFD）分析，确定动脉瘤 TWR 的血液动力学特征。
方法
纳入 9 例 11 个 MCAB 动脉瘤患者，识别其 TWR。使用 3 个参数（压力、壁面切应力（WSS）和 WSS 发散度（WSSD））进行 CFD 分析。评估每个参数与 TWR 的对应关系。
结果
在 11 个动脉瘤中，共确定了 15 个 TWR。与 CFD 参数（压力、WSS 和 WSSD）对应的比例分别为 73.33%、46.67%和 86.67%。
结论
WSSD 是一个同时考虑 WSS 大小和方向的血流动力学参数，与 TWR 的对应性最高。高 WSSD 可能与颅内动脉瘤的 TWR 相对应，而 TWR 是破裂的高风险区域。
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