Ma Long, Chen Yu, Chen Pingting, Ma Li, Yan Debin, Li Ruinan, Li Zhipeng, Zhang Haibin, Han Heze, Yuan Kexin, Li Runting, Lin Fa, Zhao Yuanli, Chen Xiaolin
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
College of Energy and Power Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China.
Front Neurol. 2024 Dec 11;15:1474857. doi: 10.3389/fneur.2024.1474857. eCollection 2024.
This study initiated a preliminary computational fluid dynamics (CFD)-based study to investigate the relationship between quantitative hemodynamics of arteriovenous malformation (AVM) draining veins and rupture.
The quantitative hemodynamics of AVM draining veins were generated from computed tomography angiography (CTA)-based steady-state CFD models. Morphological and hemodynamic parameters were compared between the ruptured and unruptured groups. The boundary conditions of the drainage vein were obtained from quantitative digital subtraction angiography (QDSA). The draining veins were divided into 15 consecutive segments to analyze the spatial distribution of the hemodynamic parameters by linear regression analysis.
From 11 AVMs, it was revealed that morphological parameters of drainage veins in ruptured and unruptured AVMs were similar. The intravascular pressure of the draining vein in the ruptured AVMs was significantly higher than those of the unruptured AVMs (pressure average: = 0.006; pressure maximum: = 0.045), and the WSS of the posterior segment was higher in ruptured AVMs ( = 0.045). WSS of draining veins in ruptured AVMs showed a linear increase trend with segmenting ( = 0.731, < 0.001), and ruptured AVMs were more likely to be accompanied by high-velocity segments in the draining vein (40.0% vs. 14.7%, = 0.037), especially in the posterior segment ( = 0.011).
The draining veins of ruptured AVMs had significantly higher intravascular pressure and posterior segment WSS. WSS showed a linear increase with segmentation in ruptured AVMs, and they often had more high-velocity segments in the draining vein, especially in the posterior segment.
本研究开展了一项基于计算流体动力学（CFD）的初步研究，以探讨动静脉畸形（AVM）引流静脉的定量血流动力学与破裂之间的关系。
基于计算机断层血管造影（CTA）的稳态CFD模型生成AVM引流静脉的定量血流动力学。比较破裂组和未破裂组的形态学和血流动力学参数。引流静脉的边界条件通过定量数字减影血管造影（QDSA）获得。将引流静脉分为15个连续节段，通过线性回归分析来分析血流动力学参数的空间分布。
在11例AVM中发现，破裂和未破裂AVM中引流静脉的形态学参数相似。破裂AVM中引流静脉的血管内压力显著高于未破裂AVM（平均压力：=0.006；最大压力：=0.045），且破裂AVM中后段的壁面切应力（WSS）更高（=0.045）。破裂AVM中引流静脉的WSS随节段划分呈线性增加趋势（=0.731，<0.001），并且破裂AVM更可能在引流静脉中伴有高速节段（40.0%对14.7%，=0.037），尤其是在后段（=0.011）。
破裂AVM的引流静脉具有显著更高的血管内压力和后段WSS。在破裂AVM中，WSS随节段划分呈线性增加，并且它们在引流静脉中通常有更多的高速节段，尤其是在后段。
