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人基底动脉的体内变形

In Vivo Deformation of the Human Basilar Artery.

作者信息

Kim Jaemin, Zhang Kaiyu, Canton Gador, Balu Niranjan, Meyer Kenneth, Saber Reza, Paydarfar David, Yuan Chun, Sacks Michael S

机构信息

James T. Willerson Center for Cardiovascular Modeling and Simulation, The Oden Institute for Computational Engineering and Sciences and the Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA.

Vascular Imaging Lab, Department of Radiology, School of Medicine, University of Washington, Seattle, WA, USA.

出版信息

Ann Biomed Eng. 2025 Jan;53(1):83-98. doi: 10.1007/s10439-024-03605-x. Epub 2024 Sep 6.

DOI:10.1007/s10439-024-03605-x
PMID:39240472
Abstract

An estimated 6.8 million people in the United States have an unruptured intracranial aneurysms, with approximately 30,000 people suffering from intracranial aneurysms rupture each year. Despite the development of population-based scores to evaluate the risk of rupture, retrospective analyses have suggested the limited usage of these scores in guiding clinical decision-making. With recent advancements in imaging technologies, artery wall motion has emerged as a promising biomarker for the general study of neurovascular mechanics and in assessing the risk of intracranial aneurysms. However, measuring arterial wall deformations in vivo itself poses several challenges, including how to image local wall motion and deriving the anisotropic wall strains over the cardiac cycle. To overcome these difficulties, we first developed a novel in vivo MRI-based imaging method to acquire cardiac gated images of the human basilar artery (BA) over the cardiac cycle. Next, complete BA endoluminal surfaces from each frame were segmented, producing high-resolution point clouds of the endoluminal surfaces. From these point clouds we developed a novel B-spline-based surface representation, then exploited the local support nature of B-splines to determine the local endoluminal surface strains. Results indicated distinct regional and temporal variations in BA wall deformation, highlighting the heterogeneous nature BA function. These included large circumferential strains (up to 20 ), and small longitudinal strains, which were often contractile and out of phase with the circumferential strains patterns. Of particular interest was the temporal phase lag in the maximum circumferential perimeter length, which indicated that the BA deforms asynchronously over the cardiac cycle. In summary, the proposed method enabled local deformation analysis, allowing for the successful reproduction of local features of the BA, such as regional principal stretches, areal changes, and pulsatile motion. Integrating the proposed method into existing population-based scores has the potential to improve our understanding of mechanical properties of human BA and enhance clinical decision-making.

摘要

据估计,美国有680万人患有未破裂的颅内动脉瘤,每年约有3万人颅内动脉瘤破裂。尽管已开发出基于人群的评分系统来评估破裂风险,但回顾性分析表明,这些评分在指导临床决策方面的应用有限。随着成像技术的最新进展,动脉壁运动已成为神经血管力学一般研究和评估颅内动脉瘤风险的一种有前景的生物标志物。然而,在体内测量动脉壁变形本身带来了几个挑战,包括如何对局部壁运动进行成像以及在心动周期中推导各向异性壁应变。为了克服这些困难,我们首先开发了一种基于磁共振成像(MRI)的新型体内成像方法,以在心动周期内获取人基底动脉(BA)的心脏门控图像。接下来,对每一帧的完整BA管腔内表面进行分割,生成管腔内表面的高分辨率点云。从这些点云中,我们开发了一种基于B样条的新型表面表示方法,然后利用B样条的局部支撑特性来确定局部管腔内表面应变。结果表明BA壁变形存在明显的区域和时间变化,突出了BA功能的异质性。这些变化包括大的圆周应变(高达20%)和小的纵向应变,纵向应变通常是收缩性的,且与圆周应变模式不同步。特别值得关注的是最大圆周周长的时间相位滞后,这表明BA在心动周期中变形是异步的。总之,所提出的方法能够进行局部变形分析,从而成功再现BA的局部特征,如区域主拉伸、面积变化和脉动运动。将所提出的方法整合到现有的基于人群的评分系统中,有可能提高我们对人BA力学特性的理解,并增强临床决策能力。

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本文引用的文献

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Intracranial aneurysm wall displacement depicted by amplified Flow predicts growth.经放大血流显示的颅内动脉瘤壁移位预示着动脉瘤的生长。
J Neurointerv Surg. 2024 Feb 6. doi: 10.1136/jnis-2023-021227.
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Popliteal artery aneurysm ultrasound criteria for reporting characteristics.腘动脉动脉瘤报告特征的超声标准。
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The influence of sac centreline on saccular aneurysm rupture: computational study.囊中心连线对囊状动脉瘤破裂的影响:计算研究。
Sci Rep. 2023 Jul 12;13(1):11288. doi: 10.1038/s41598-023-38466-2.
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Multi-Planar, Multi-Contrast and Multi-Time Point Analysis Tool (MOCHA) for Intracranial Vessel Wall Characterization.颅内血管壁特征分析的多平面、多对比和多时间点分析工具(MOCHA)
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Non-Invasive Assessment of Damping of Blood Flow Velocity Pulsatility in Cerebral Arteries With MRI.应用 MRI 技术无创性评估脑动脉血流速度搏动的阻尼
J Magn Reson Imaging. 2022 Jun;55(6):1785-1794. doi: 10.1002/jmri.27989. Epub 2021 Nov 18.
6
Monocyte-based inflammatory indices predict outcomes following aneurysmal subarachnoid hemorrhage.基于单核细胞的炎症指标预测蛛网膜下腔出血后结局。
Neurosurg Rev. 2021 Dec;44(6):3499-3507. doi: 10.1007/s10143-021-01525-1. Epub 2021 Apr 10.
7
Performance of Aneurysm Wall Enhancement Compared with Clinical Predictive Scales: PHASES, ELAPSS, and UIATS.动脉瘤壁增强表现与临床预测量表的比较:PHASES、ELAPSS 和 UIATS。
World Neurosurg. 2021 Mar;147:e538-e551. doi: 10.1016/j.wneu.2020.12.123. Epub 2020 Dec 31.
8
Amplified Flow Imaging (aFlow): A Novel MRI-Based Tool to Unravel the Coupled Dynamics Between the Human Brain and Cerebrovasculature.增强血流成像(aFlow):一种新的基于 MRI 的工具,用于揭示人脑和脑血管之间的耦合动力学。
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Retrospective application of risk scores to ruptured intracranial aneurysms: would they have predicted the risk of bleeding?回顾性应用风险评分对破裂颅内动脉瘤的评估:它们能否预测出血风险?
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Is the unruptured intracranial aneurysm treatment score (UIATS) sensitive enough to detect aneurysms at risk of rupture?未破裂颅内动脉瘤治疗评分(UIATS)是否足够敏感以检测有破裂风险的动脉瘤?
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