Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate Prefecture, Japan.
Department of Neurosurgery, Mie Chuo Medical Center, Mie Prefecture, Japan.
J Stroke Cerebrovasc Dis. 2019 Nov;28(11):104339. doi: 10.1016/j.jstrokecerebrovasdis.2019.104339. Epub 2019 Aug 24.
Infarcts in the lateral striate artery (LSA) territory can be caused by several pathological changes, including lipohyalinosis and microatheroma. However, fluid dynamic effects on these changes remain unknown. Thus, we investigated whether the fluid dynamic metrics of the LSAs were altered in patients with acute ischemic stroke using computational fluid dynamics (CFD) analysis.
Fifty-one patients with acute ischemic stroke confined in the basal ganglia and/or corona radiata underwent high-resolution magnetic resonance angiography (HR-MRA) at 7T. We performed CFD analyses to obtain indices including the wall shear stress (WSS), WSS gradient (WSSG), and flow velocity (FV) and compared these values between the ipsilesional and contralesional sides in the patients with infarcts in the LSA or non-LSA territories.
In patients with LSA-territory infarcts, the WSS, WSSG, and FV values were significantly lower in the ipsilesional LSAs than in the contralesional LSAs (P = .01-.03), while these values in the proximal middle cerebral arteries showed no significant lateralities. In contrast, in patients with non-LSA-territory infarcts, there were no significant lateralities in the metrics between the ipsilesional and contralesional sides.
The CFD analyses using HR-MRA revealed significantly low WSS and WSSG values of the ipsilesional LSAs compared with that of the contralesional side in patients with LSA-territory infarcts, suggesting that fluid dynamic factors of LSAs can be one of the risk factors for LSA-territory infarctions.
外侧纹状动脉（LSA）区域的梗死可由多种病理变化引起，包括脂肪透明变性和微动脉粥样硬化。然而，这些变化的流体动力学效应尚不清楚。因此，我们通过计算流体动力学（CFD）分析研究了 LSA 的流体动力学指标是否在急性缺血性脑卒中患者中发生改变。
51 例局限于基底节和/或放射冠的急性缺血性脑卒中患者在 7T 行高分辨率磁共振血管造影（HR-MRA）。我们进行 CFD 分析以获得包括壁面切应力（WSS）、WSS 梯度（WSSG）和流速（FV）在内的指标，并比较了 LSA 或非 LSA 区域梗死患者患侧和对侧 LSA 之间的这些值。
在 LSA 区域梗死的患者中，患侧 LSA 的 WSS、WSSG 和 FV 值明显低于对侧 LSA（P =.01-.03），而近端大脑中动脉的这些值无明显侧别差异。相比之下，在非 LSA 区域梗死的患者中，这些指标在患侧和对侧之间无明显侧别差异。
使用 HR-MRA 的 CFD 分析显示，与对侧 LSA 相比，LSA 区域梗死患者患侧 LSA 的 WSS 和 WSSG 值明显较低，提示 LSA 的流体动力学因素可能是 LSA 区域梗死的危险因素之一。
