Liang Xinyu, Peng Fei, Yao Yunchu, Yang Yuting, Liu Aihua, Chen Duanduan
School of Life Sciences, Beijing Institute of Technology, Beijing, China.
Neurointerventional Center, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Aging Neurosci. 2023 Mar 13;15:1145542. doi: 10.3389/fnagi.2023.1145542. eCollection 2023.
Intracranial fusiform aneurysms (IFAs) are considered to have a complex pathophysiology process and poor natural history. The purpose of this study was to investigate the pathophysiological mechanisms of IFAs based on the characteristics of aneurysm wall enhancement (AWE), hemodynamics, and morphology.
A total of 21 patients with 21 IFAs (seven fusiform types, seven dolichoectatic types, and seven transitional types) were included in this study. Morphological parameters of IFAs were measured from the vascular model, including the maximum diameter (D), maximum length (L), and centerline curvature and torsion of fusiform aneurysms. The three-dimensional (3D) distribution of AWE in IFAs was obtained based on high-resolution magnetic resonance imaging (HR-MRI). Hemodynamic parameters including time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), gradient oscillatory number (GON), and relative residence time (RRT) were extracted by computational fluid dynamics (CFD) analysis of the vascular model, and the relationship between these parameters and AWE was investigated.
The results showed that D ( = 0.007), L ( = 0.022), enhancement area ( = 0.002), and proportion of enhancement area ( = 0.006) were significantly different among three IFA types, and the transitional type had the largest D, L, and enhancement area. Compared with the non-enhanced regions of IFAs, the enhanced regions had lower TAWSS but higher OSI, GON, and RRT ( < 0.001). Furthermore, Spearman's correlation analysis showed that AWE was negatively correlated with TAWSS, but positively correlated with OSI, GON, and RRT.
There were significant differences in AWE distributions and morphological features among the three IFA types. Additionally, AWE was positively associated with the aneurysm size, OSI, GON, and RRT, while negatively correlated with TAWSS. However, the underlying pathological mechanism of the three fusiform aneurysm types needs to be further studied.
颅内梭形动脉瘤（IFAs）被认为具有复杂的病理生理过程且自然病史不佳。本研究的目的是基于动脉瘤壁强化（AWE）、血流动力学和形态学特征来探讨IFAs的病理生理机制。
本研究纳入了21例患有21个IFAs的患者（7例梭形类型、7例迂曲扩张型和7例过渡型）。从血管模型测量IFAs的形态学参数，包括最大直径（D）、最大长度（L）以及梭形动脉瘤的中心线曲率和扭转。基于高分辨率磁共振成像（HR-MRI）获得IFAs中AWE的三维（3D）分布。通过对血管模型进行计算流体动力学（CFD）分析提取包括时间平均壁面切应力（TAWSS）、振荡切变指数（OSI）、梯度振荡数（GON）和相对停留时间（RRT）在内的血流动力学参数，并研究这些参数与AWE之间的关系。
结果显示，三种IFAs类型之间的D（=0.007）、L（=0.022）、强化面积（=0.002）和强化面积比例（=0.006）存在显著差异，过渡型具有最大的D、L和强化面积。与IFAs的非强化区域相比，强化区域的TAWSS较低，但OSI、GON和RRT较高（<0.001）。此外，Spearman相关性分析表明，AWE与TAWSS呈负相关，但与OSI、GON和RRT呈正相关。
三种IFAs类型之间的AWE分布和形态特征存在显著差异。此外，AWE与动脉瘤大小、OSI、GON和RRT呈正相关，而与TAWSS呈负相关。然而，三种梭形动脉瘤类型的潜在病理机制仍需进一步研究。
