Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Clin Neurol Neurosurg. 2023 Aug;231:107860. doi: 10.1016/j.clineuro.2023.107860. Epub 2023 Jun 26.
The purpose of this work was to investigate the relationship between the geometric factors and the hemodynamics of the stenotic carotid artery.
We retrospectively reviewed data of patients with carotid stenosis (40%-95%). The Navier-Stokes equations were solved using ANSYS CFX 18.0. Correlation analysis was based on Spearman's test. Geometric variables (p < 0.1 in the univariate analysis) were entered into the logistical regression. A receiver-operating characteristics analysis was used to detect hemodynamically significant lesions.
81 patients (96 arteries) were evaluated. The logistic regression analysis revealed that the translesional pressure ratio was significantly correlated with the stenosis degree (OR = 1.147, p < 0.001) and the angle between internal carotid artery and external carotid artery (angle γ) (OR = 0.933, p = 0.01). The translesional wall shear stress ratio was significantly correlated with stenosis degree (OR = 1.094, p < 0.001), lesion length (OR = 0.873, p = 0.01), lumen area of internal carotid artery (OR = 0.867, p = 0.002), and lumen area of common carotid artery (OR = 1.058, p = 0.01). For predicting low translesional pressure ratio, the AUC was 0.71 (p < 0.001) for angle γ, and was 0.87 (p < 0.001) for stenosis degree. For predicting high translesional wall shear stress ratio, the AUC was 0.62 (p = 0.04) for lumen area of internal carotid artery, and was 0.77 (p < 0.001) for stenosis degree.
Apart from stenosis degree, other geometric characteristics of lesions may also have an influence on hemodynamics of the stenotic carotid artery.
本研究旨在探讨狭窄颈动脉的几何因素与血流动力学之间的关系。
我们回顾性分析了 40%-95%颈动脉狭窄患者的数据。使用 ANSYS CFX 18.0 求解纳维-斯托克斯方程。基于 Spearman 检验进行相关性分析。将几何变量（单因素分析中 p<0.1）纳入逻辑回归。使用受试者工作特征分析来检测血流动力学意义上的狭窄病变。
共评估了 81 例患者（96 条动脉）。逻辑回归分析显示，跨狭窄压力比与狭窄程度显著相关（OR=1.147，p<0.001），与颈内动脉和颈外动脉之间的夹角（γ角）显著相关（OR=0.933，p=0.01）。跨狭窄壁面切应力比与狭窄程度显著相关（OR=1.094，p<0.001），与病变长度显著相关（OR=0.873，p=0.01），与颈内动脉管腔面积显著相关（OR=0.867，p=0.002），与颈总动脉管腔面积显著相关（OR=1.058，p=0.01）。预测低跨狭窄压力比时，γ角的 AUC 为 0.71（p<0.001），狭窄程度的 AUC 为 0.87（p<0.001）。预测高跨狭窄壁面切应力比时，颈内动脉管腔面积的 AUC 为 0.62（p=0.04），狭窄程度的 AUC 为 0.77（p<0.001）。
除了狭窄程度外，病变的其他几何特征也可能对狭窄颈动脉的血流动力学产生影响。
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