Department of Neurosurgery, College of Medicine, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Korea.
Department of Mechanical Engineering, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan, Gyeonggi-do, 15588, Korea.
Sci Rep. 2020 Oct 26;10(1):18237. doi: 10.1038/s41598-020-75362-5.
Cerebral aneurysms should be treated on the basis of accurate rupture risk prediction. Nowadays, the rupture risk in aneurysms has been estimated using hemodynamic parameters. In this paper, we suggest a new way to predict the rupture risks in cerebral aneurysms by using fluid-structure interaction (FSI) analysis for better decision-making regarding treatment. A patient-specific model was constructed using digital subtraction angiography of 51 cerebral aneurysms. For each model, a thin-walled area (TWA) was first predicted using computational fluid dynamics (CFD), and then the highest equivalent strain in the TWA was calculated with FSI by varying wall thicknesses and mechanical properties. A critical curve was made from 16 FSI results for each patient-specific model to estimate the rupture risk. On average, the equivalent strains of the ruptured aneurysms were higher than those of the unruptured aneurysms. Furthermore, the patterns of critical curves between unruptured and ruptured aneurysms were clearly distinguishable. From the rupture risk evaluation based on the cut-off value, 24 of the 27 unruptured aneurysms and 15 of the 24 ruptured aneurysms were matched with actual-clinical setting cases. The critical curve proposed in the present study could be an effective tool for the prediction of the rupture risk of aneurysm.
脑动脉瘤应基于准确的破裂风险预测进行治疗。如今，已经使用血流动力学参数来估计动脉瘤的破裂风险。在本文中，我们建议通过使用流固耦合（FSI）分析来预测脑动脉瘤的破裂风险，以便更好地进行治疗决策。使用 51 个脑动脉瘤的数字减影血管造影术构建了一个患者特异性模型。对于每个模型，首先使用计算流体动力学（CFD）预测薄壁区（TWA），然后通过改变壁厚和力学特性，使用 FSI 计算 TWA 中的最高等效应变。从每个患者特定模型的 16 个 FSI 结果中制作一条临界曲线，以估计破裂风险。平均而言，破裂动脉瘤的等效应变高于未破裂动脉瘤。此外，未破裂和破裂动脉瘤之间的临界曲线模式明显不同。根据截止值进行的破裂风险评估，27 个未破裂动脉瘤中的 24 个和 24 个破裂动脉瘤中的 15 个与实际临床情况相匹配。本研究提出的临界曲线可以成为预测动脉瘤破裂风险的有效工具。
