Hori Emiko, Hori Satoshi, Oya Kimiko, Ko Masaki, Kashiwazaki Daina, Okamoto Soshi, Shibata Takashi, Kubo Michiya, Horie Yukio, Kuroda Satoshi
Department of Neurosurgery, Saiseikai Toyama Hospital.
No Shinkei Geka. 2020 Jan;48(1):15-23. doi: 10.11477/mf.1436204128.
The rupture risk of cerebral aneurysms is determined by various factors. However, it is not clear whether the thickness of the aneurysm wall also influences the rupture risk. In this study, under the assumption that thin-walled aneurysms have a higher rupture risk compared with thick-wall aneurysms, we evaluate the usefulness of computed fluid dynamics(CFD)to identify thin-walled cerebral aneurysms.
Fifty-four unruptured middle cerebral aneurysms from 53 patients were analyzed using CFD before the operation. We divided these aneurysms into two groups: translucent-type aneurysms and others. To analyze the difference of these groups, individual elements(age, gender, volume, and aspect ratio)and hemodynamic factors(wall shear stress[WSS], flow coefficient, and flow coefficient per volume)were examined using CFD.
Univariate analysis detected significant relationships between the translucent-type aneurysms and gender, aspect ratio, WSS and flow coefficient per volume. Multiple logistics regression also identified a significant relationship with gender and flow coefficient per volume. The receiver operating characteristic curve demonstrated that the flow coefficient per volume could predict translucent-type aneurysms(area under the curve 0.84, cut-off value 1.32, sensitivity 76.2%, and specificity 87.9%).
Gender and the flow coefficient per volume could predict translucent-type aneurysms of the middle cerebral artery. CFD analysis might be a useful tool to predict translucent-type aneurysms.
脑动脉瘤的破裂风险由多种因素决定。然而，动脉瘤壁的厚度是否也会影响破裂风险尚不清楚。在本研究中，假设薄壁动脉瘤比厚壁动脉瘤具有更高的破裂风险，我们评估计算流体动力学（CFD）识别薄壁脑动脉瘤的有效性。
术前使用CFD分析了53例患者的54个未破裂大脑中动脉瘤。我们将这些动脉瘤分为两组：半透明型动脉瘤和其他类型。为分析这些组之间的差异，使用CFD检查了个体因素（年龄、性别、体积和纵横比）和血流动力学因素（壁面剪应力[WSS]、流量系数和每体积流量系数）。
单因素分析发现半透明型动脉瘤与性别、纵横比、WSS和每体积流量系数之间存在显著关系。多元逻辑回归也确定了与性别和每体积流量系数的显著关系。受试者工作特征曲线表明，每体积流量系数可预测半透明型动脉瘤（曲线下面积0.84，截断值1.32，敏感性76.2%，特异性87.9%）。
性别和每体积流量系数可预测大脑中动脉的半透明型动脉瘤。CFD分析可能是预测半透明型动脉瘤的有用工具。
