Jiang Yeqing, Ge Liang, Lu Gang, Wan Hailin, Chen Qi, Zou Rong, Leng Xiaochang, Xiang Jianping, Zhang Xiaolong
Huashan Hospital, Fudan University, Shanghai, China.
ArteryFlow Technology Co., Ltd, Hangzhou, China.
Front Neurol. 2023 Jun 2;14:1108904. doi: 10.3389/fneur.2023.1108904. eCollection 2023.
To analyze how wall enhancement affects hemodynamics and cerebral ischemic risk factors in vertebrobasilar non-saccular intracranial aneurysms (VBNIAs).
Ten consecutive non-saccular aneurysms were collected, including three transitional vertebrobasilar dolichoectasia (TVBD). A wall enhancement model was quantitatively constructed to analyze how wall enhancement interacts with hemodynamics and cerebral ischemic factors.
Enhanced area revealed low wall shear stress (WSS) and wall shear stress gradient (WSSG), with high oscillatory shear index (OSI), relative residence time (RRT), and gradient oscillatory number (GON) while the vortex and slow flow region in fusiform aneurysms are similar to TVBD fusiform aneurysms. With low OSI, high RRT and similar GON in the dilated segment, the enhanced area still manifests low WSS and WSSG in the slow flow area with no vortex. In fusiform aneurysms, wall enhancement was negatively correlated with WSS (except for case 7, all values < 0.05, = -0.52 ~ -0.95), while wall enhancement was positively correlated with OSI (except for case 5, all values < 0.05, = 0.50 ~ 0.83). For the 10 fusiform aneurysms, wall enhancement is significantly positively correlated with OSI ( = 0.0002, = 0.75) and slightly negatively correlated with WSS ( = 0.196, = -0.30) throughout the dataset. Aneurysm length, width, low wall shear stress area (LSA), high OSI, low flow volume (LFV), RRT, and high aneurysm-to-pituitary stalk contrast ratio (CRstalk) area plus proportion may be predictive of cerebral ischemia.
A wall enhancement quantitative model was established for vertebrobasilar non-saccular aneurysms. Low WSS was negatively correlated with wall enhancement, while high OSI was positively correlated with wall enhancement. Fusiform aneurysm hemodynamics in TVBD are similar to simple fusiform aneurysms. Cerebral ischemia risk appears to be correlated with large size, high OSI, LSA, and RRT, LFV, and wall enhancement.
分析壁强化如何影响椎基底动脉非囊状颅内动脉瘤（VBNIA）的血流动力学和脑缺血危险因素。
连续收集10例非囊状动脉瘤，其中包括3例过渡性椎基底动脉迂曲扩张（TVBD）。构建壁强化模型以定量分析壁强化与血流动力学及脑缺血因素之间的相互作用。
强化区域显示壁面切应力（WSS）和壁面切应力梯度（WSSG）较低，振荡切应力指数（OSI）、相对停留时间（RRT）和梯度振荡数（GON）较高，而梭形动脉瘤中的涡流和缓慢流动区域与TVBD梭形动脉瘤相似。在扩张段，OSI较低、RRT较高且GON相似，强化区域在无涡流的缓慢流动区域仍表现出较低的WSS和WSSG。在梭形动脉瘤中，壁强化与WSS呈负相关（病例7除外，所有P值＜0.05，r = -0.52至-0.95），而壁强化与OSI呈正相关（病例5除外，所有P值＜0.05，r = 0.50至0.83）。对于这10例梭形动脉瘤，在整个数据集中，壁强化与OSI显著正相关（P = 0.0002，r = 0.75），与WSS呈轻度负相关（P = 0.196，r = -0.30）。动脉瘤长度、宽度、低壁面切应力面积（LSA）、高OSI、低血流量（LFV）、RRT以及高动脉瘤与垂体柄对比率（CRstalk）面积加比例可能是脑缺血的预测指标。
建立了椎基底动脉非囊状动脉瘤的壁强化定量模型。低WSS与壁强化呈负相关，而高OSI与壁强化呈正相关。TVBD中的梭形动脉瘤血流动力学与单纯梭形动脉瘤相似。脑缺血风险似乎与大尺寸、高OSI、LSA以及RRT、LFV和壁强化相关。
