Department of Neurological Surgery, Ryofukai Satoh Neurosurgical Hospital, 5-23-23 Matsunaga, Fukuyama, Hiroshima, 729-0104, Japan.
Department of Contemporary Welfare, Faculty of Health and Welfare, Okayama Prefectural University, Okayama, Japan.
Sci Rep. 2024 Sep 27;14(1):22231. doi: 10.1038/s41598-024-73217-x.
Microvascular decompression (MVD) has proven efficacy in trigeminal neuralgia (TN) and hemifacial spasm (HFS). This study utilized computational fluid dynamics (CFD) to investigate the impact of MVD on wall shear stress (WSS) of responsible arteries (RAs) at the neurovascular contact (NVC). A total of 21 cases (10 TN, 11 HFS) were analyzed, involving RAs at NVC validated through intraoperative photographs. Hemodynamic parameters (WSS, vessel diameter, flow rate, pressure drop) was calculated using CFD for the RAs based on 3D silent-magnetic resonance angiograms. The NVC was segmented into NVC-proximal, NVC-site, and NVC-distal portions using simulated 3D CFD images that correlated with surgical observations. WSS ratios of NVC-site to NVC-proximal (NVC-site/proximal) was calculated both before and after MVD. Prior to MVD, WSS in the RA at the NVC displayed a peaked curve with a maximum at NVC-site; however, post MVD, it presented a smooth curve without peaks. The WSS ratio exhibited a significant decrease after MVD. The impact of MVD on WSS of RAs at NVC was evaluated in both TN and HFS cases. Analyzing the hemodynamics of RAs through CFD and identifying WSS peaks at NVC portions before MVD provided a more detailed and localized understanding of the morphologically depicted NVC.
微血管减压术（MVD）已被证明对三叉神经痛（TN）和面肌痉挛（HFS）有效。本研究利用计算流体动力学（CFD）研究 MVD 对神经血管接触（NVC）处责任动脉（RA）壁切应力（WSS）的影响。共分析了 21 例（10 例 TN，11 例 HFS），涉及通过术中照片验证的 NVC 处的 RA。使用 CFD 根据 3D 磁共振血管造影术计算 RA 的血流动力学参数（WSS、血管直径、流速、压降）。使用模拟的 3D CFD 图像对 NVC 进行分段，将 NVC 近端、NVC 部位和 NVC 远端与手术观察相关联。计算 MVD 前后 NVC 部位与 NVC 近端（NVC-site/proximal）的 WSS 比值。MVD 前，NVC 处 RA 的 WSS 显示出峰值曲线，最大值在 NVC-site；然而，MVD 后，它呈现出平滑的曲线，没有峰值。MVD 后 WSS 比值显著下降。评估了 MVD 对 TN 和 HFS 病例中 NVC 处 RA 的 WSS 的影响。通过 CFD 分析 RA 的血液动力学，并在 MVD 前识别 NVC 部位的 WSS 峰值，为形态描述的 NVC 提供了更详细和局部的理解。
