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一对罕见同卵双胞胎的脑动脉和动脉瘤的形态学与血流动力学

Morphology and Hemodynamics of Cerebral Arteries and Aneurysms in a Rare Pair of Monozygotic Twins.

作者信息

Yi Hang, Yang Zifeng, Bramlage Luke C, Ludwig Bryan R

机构信息

Department of Mechanical and Materials Engineering, Wright State University, Dayton, OH 45435, USA.

Division of NeuroInterventional Surgery, Department of Neurology, Wright State University/Premier Health-Clinical Neuroscience Institute, 30E Apple St., Dayton, OH 45409, USA.

出版信息

Diagnostics (Basel). 2023 Jun 8;13(12):2004. doi: 10.3390/diagnostics13122004.

Abstract

In this preliminary study, the underlying pathophysiology mechanisms of cerebral aneurysms (CAs) in monozygotic twins (MTs) were investigated via a rare pair of MTs (twin A and twin B) involving four reconstructed arterial models using preclinical information. First, dimensions and configurated outlines of three-perspective geometries were compared. Adopting an in-vitro validated numerical CA model, hemodynamic characteristics were investigated in the MTs, respectively. Despite expected genetic similarities, morphological comparisons show that configurations of cerebral arteries exhibit significant differences between the twins. The ICA size of twin A is larger than that in twin B (2.2325.86%), varying with specific locations, attributing to variations during embryological developments and environmental influences. Numerical modeling indicates the MTs have some hemodynamic similarities such as pressure distributions (13,400 Pa) and their oscillatory shear index (OSI) (0~0.49), but present significant differences in local regions. Specifically, the difference in blood flow rate in the MTs is from 16% to 221%, varying with specifically compared arteries. The maximum time-averaged wall shear stress (53.6 Pa vs. 37.8 Pa) and different local OSI distributions were also observed between the MTs. The findings revealed that morphological variations in MTs could be generated by embryological and environmental factors, further influencing hemodynamic characteristics on CA pathophysiology.

摘要

在这项初步研究中,通过一对罕见的同卵双胞胎(双胞胎A和双胞胎B),利用临床前信息对涉及四个重建动脉模型的同卵双胞胎脑动脉瘤(CA)的潜在病理生理机制进行了研究。首先,比较了三维几何结构的尺寸和轮廓。采用经过体外验证的数值CA模型,分别研究了这对同卵双胞胎的血流动力学特征。尽管预期存在遗传相似性,但形态学比较表明,双胞胎之间脑动脉的形态存在显著差异。双胞胎A的颈内动脉尺寸大于双胞胎B(2.23%25.86%),且因具体位置而异,这归因于胚胎发育过程中的变异和环境影响。数值模拟表明,这对同卵双胞胎在一些血流动力学方面存在相似性,如压力分布(约13400帕)及其振荡剪切指数(OSI)(00.49),但在局部区域存在显著差异。具体而言,这对同卵双胞胎的血流速度差异在16%至221%之间,因具体比较的动脉而异。在这对同卵双胞胎之间还观察到最大时间平均壁面剪切应力(53.6帕对37.8帕)和不同的局部OSI分布。研究结果表明,同卵双胞胎的形态变异可能由胚胎学和环境因素产生,进而影响脑动脉瘤病理生理的血流动力学特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16ce/10297053/f9f8746d659e/diagnostics-13-02004-g001.jpg

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