Ishida Fujimaro, Tsuji Masanori, Tanioka Satoru, Tanaka Katsuhiro, Yoshimura Shinichi, Suzuki Hidenori
Department of Neurosurgery, Mie Chuo Medical Center, NHO, Tsu, Japan
Department of Neurosurgery, Hyogo College of Medicine, Hyogo, Japan
Hemodynamics is thought to play an important role in the pathogenesis of cerebral aneurysms and recent development of computer technology makes it possible to simulate blood flow using high-resolution 3D images within several hours. A lot of studies of computational fluid dynamics (CFD) for cerebral aneurysms were reported; therefore, application of CFD for cerebral aneurysms in clinical settings is reviewed in this article. CFD for cerebral aneurysms using a patient-specific geometry model was first reported in 2003 and it has been revealing that hemodynamics brings a certain contribution to understanding aneurysm pathology, including initiation, growth and rupture. Based on the knowledge of the state-of-the-art techniques, this review treats the decision-making process for using CFD in several clinical settings. We introduce our CFD procedure using digital imaging and communication in medicine (DICOM) datasets of 3D CT angiography or 3D rotational angiography. In addition, we review rupture status, hyperplastic remodeling of aneurysm wall, and recurrence of coiled aneurysms using the hemodynamic parameters such as wall shear stress (WSS), oscillatory shear index (OSI), aneurysmal inflow rate coefficient (AIRC), and residual flow volume (RFV).
血流动力学被认为在脑动脉瘤的发病机制中起重要作用，并且计算机技术的最新发展使得在数小时内使用高分辨率3D图像模拟血流成为可能。已经报道了许多关于脑动脉瘤的计算流体动力学（CFD）研究；因此，本文综述了CFD在临床环境中对脑动脉瘤的应用。2003年首次报道了使用患者特异性几何模型的脑动脉瘤CFD，并且已经表明血流动力学对理解动脉瘤病理，包括起始、生长和破裂，有一定贡献。基于最新技术的知识，本综述探讨了在几种临床环境中使用CFD的决策过程。我们介绍了使用3D CT血管造影或3D旋转血管造影的医学数字成像和通信（DICOM）数据集的CFD程序。此外，我们使用壁面切应力（WSS）、振荡切变指数（OSI）、动脉瘤流入率系数（AIRC）和残余血流量（RFV）等血流动力学参数来综述动脉瘤的破裂状态、瘤壁的增生性重塑和栓塞后动脉瘤的复发情况。
