[1]邹成功　唐　辉　邵　川等.颅内破裂动脉瘤的血流动力学特征：基于流固耦合技术的计算流体力学模拟分析[J].中国临床神经外科杂志,2021,26(11):849-852.[doi:10.13798/j.issn.1009-153X.2021.11.010]
　ZOU Cheng-gong,TANG Hui,SHAO Chuan,et al.Hemodynamic characteristics of rupture point and aneurysm sac of ruptured intracranial aneurysms: computational fluid dynamics simulation and analysis based on fluid-structure coupling technology[J].,2021,26(11):849-852.[doi:10.13798/j.issn.1009-153X.2021.11.010]
点击复制

颅内破裂动脉瘤的血流动力学特征：基于流固耦合技术的计算流体力学模拟分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年11期
页码:
849-852
栏目:
实验研究
出版日期:
2021-11-25

文章信息/Info

Title:
Hemodynamic characteristics of rupture point and aneurysm sac of ruptured intracranial aneurysms: computational fluid dynamics simulation and analysis based on fluid-structure coupling technology
文章编号:
1009-153X（2021）11-0849-04
作者:
邹成功　唐　辉　邵　川等
6370001 四川，南充市中心医院/川北医学院第二临床学院神经外科（邹成功、唐　辉、邵　川、王潇娅、孙　谋、杨　荣、章　涛、何家全）
Author(s):
ZOU Cheng-gong;  TANG Hui;  SHAO Chuan;  et al
Department of Neurosurgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong 637000, China
关键词:
颅内破裂动脉瘤; 血流动力学; 破裂点; 动脉瘤瘤囊
Keywords:
Intracranial ruptured aneurysm;  Hemodynamics;  Rupture point;  Aneurysm sac
分类号:
R 743.9
DOI:
10.13798/j.issn.1009-153X.2021.11.010
文献标志码:
A
摘要:
目的 探讨颅内破裂动脉瘤破裂点和瘤囊处血流动力学特征。方法 选择2018年1月至2019年6月收治的颅内破裂动脉瘤21例，根据术前CTA、DSA数据三维重建动脉瘤模型，采用ANSYS软件计算动脉瘤破裂点和瘤囊处血流动力相关参数[壁剪切应力（WSS）、切应力震荡指数（OSI）]。结果 动脉瘤破裂点WSS[（0.215±0.047）Pa]明显低于瘤囊WSS[（0.464±0.148）Pa；P<0.001]。动脉瘤破裂点OSI[（0.035±0.024）]与瘤囊OSI[（0.030±0.016）]无统计学差异（P>0.05）。在一个心动周期中，随着血流动力学的变化，动脉瘤形态出现规律的变化，载瘤动脉及动脉瘤的形态变化存在明显差异，即动脉瘤两侧壁的形态变化相对较小，动脉瘤破裂点处形态变化明显。结论 颅内动脉瘤破裂点较动脉瘤囊WSS更低而形态变化更大，颅内动脉瘤破裂与WSS呈负相关，而与形态变化呈正相关。
Abstract:
Objective To explore the hemodynamic characteristics of the rupture point and aneurysm sac of the ruptured intracranial aneurysms. Methods The three-dimensional aneurysmal models were reconstructed using three-dimensional reconstruction technique using the preoperative CTA and DSA data obtained from 21 patients with ruptured intracrainel aneurysm who were admitted to our hospital from January 2018 to June 2019. The hemodynamic parameters including wall shear stress (WSS) and shear stress oscillation index (OSI), blood flow velocity and shape were calculated by computational fluid dynamic simulation using ANSYS software. Results The mean WSS [(0.215±0.047) Pa] of the rupture point was significantly lower than taht [(0.464±0.148) Pa] of the aneurysm sac (P<0.001). There was no statistical differcnce in OSI between the rupture point and the aneurysm sac [(0.035±0.024) vs. (0.030±0.016); P>0.05]. In a cardiac cycle, the shape of the aneurysm changed regularly with the change of hemodynamics. There were obvious differences in the morphological changes of the parent arteries and the aneurysms. The morphological changes at the rupture point were more obvious than the aneurysm sac. Conclusions The WSS of rupture point in intracranial aneurysm is lower than that of the aneurysm sac, but the morphological changes are more obvious. The rupture of intracranial aneurysm is negatively correlated with the WSS, but is positively correlated with the morphological changes.

参考文献/References:

[1] Sforza DM, Putman CM, Cebral JR. Hemodynamics of cere-bral aneurysms [J]. Annu Rev Fluid Mech, 2009, 41: 91-107.
[2] 朱作磊，罗良生. 动脉瘤性蛛网膜下腔出血的预后相关因素研究进展[J]. 中国临床神经外科杂志，2016，21（3）：183-184，187.
[3] Fukuda S, Shimogonya Y, Yonemoto N, et al. Differences in cerebral aneurysm rupture rate according to arterial anato-mies depend on the hemodynamic environment [J]. AJNRAm J Neuroradiol, 2019, 40(5): 834-839.
[4] Krings T, Mandell DM, Kiehl TR, et al. Intracranial aneu-rysms: from vessel wall pathology to therapeutic approach [J]. Nat Rev Neurol, 2011, 7(10): 547-559.
[5] Sherif C, Krssak M. Evaluation of cerebral aneurysm wall thickness in experimental aneurysms: comparison of 3T-MR imaging with direct microscopic measurements [J]. ActaNeurochir (Wien), 2014, 156(1): 27-34.
[6] Shojima M, Oshima M, Takagi K, et al. Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms [J]. Stroke, 2004, 35: 2500-2505.
[7] Muthachen NR, Sethuraman M. Anesthetic management of a patient with Takotsubo cardiomyopathy presenting for sur-gical clipping of intracranial aneurysm [J]. Anaesthesiol Clin Pharmacol, 2017, 33(4): 547-548.
[8] Nixon AM, Gunel M, Sumpio BE. The critical role of hemo-dynamics in the development of cerebral vascular disease [J]. Neurosurg, 2010, 112(6): 1240-1253.
[9] Fan J, Wang Y, Liu J, et al. Morphological-hemodynamic characteristics of intracranial bifurcation mirror aneurysms [J]. World Neurosurg, 2015, 84(1): 114.

相似文献/References:

[1]张晓燕　张　穗　宋利亚.颅内破裂动脉瘤急诊夹闭术围手术期护理[J].中国临床神经外科杂志,2016,(05):308.[doi:10.13798/j.issn.1009-153X.2016.05.019]
[2]伍　杰　杨　铭　潘　力　蔡明俊　刘　鹏　秦　杰　杨　柳　安学锋　李国栋　马廉亭.颅内破裂动脉瘤合并脑内血肿的复合手术治疗[J].中国临床神经外科杂志,2016,(04):193.[doi:10.13798/j.issn.1009-153X.2016.04.001]
　WU Jie,YANG Ming,PAN Li,et al.Clinical observation of hybrid surgery on ruptured intracranial aneurysms associated with cerebral hematomas (report of 5 cases)[J].,2016,(11):193.[doi:10.13798/j.issn.1009-153X.2016.04.001]
[3]符传艺　陈健龙　张　茂　刘朝晖　黄垂学　黄　军　马建荣　赵建农.表现为脑室出血的颅内破裂动脉瘤的诊治[J].中国临床神经外科杂志,2016,(04):234.[doi:10.13798/j.issn.1009-153X.2016.04.014]
[4]张　莹　荆林凯　张倩倩　刘　健　张义森　王　坤　穆士卿　杨新健.颈内动脉后交通动脉小动脉瘤破裂危险因素分析[J].中国临床神经外科杂志,2016,(03):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
　ZHANG Ying,JING Lin-kai,ZHANG Qian-qian,et al.Analysis of risk factors related to rupture of small (diameter ≤5 mm) posterior communicating artery aneurysms[J].,2016,(11):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
[5]郑鉴峰　郭宗铎　张晓冬　朱　继　何朝晖　孙晓川.开颅夹闭术和血管内栓塞术治疗老年前交通动脉破裂动脉瘤的疗效对比分析[J].中国临床神经外科杂志,2016,(03):150.[doi:10.13798/j.issn.1009-153X.2016.03.006]
　ZHENG Jian-feng,GUO Zong-duo,ZHANG Xiao-dong,et al.Craniotomy clipping and interventional treatment of ruptured anterior communicating artery aneurysms in elderly patients: comparison of curative effects[J].,2016,(11):150.[doi:10.13798/j.issn.1009-153X.2016.03.006]
[6]李玉龙　方兴根　李真保　吴德刚　赖年升　赵心同　徐善水　狄广福.血管内治疗颈内动脉床突旁破裂动脉瘤[J].中国临床神经外科杂志,2016,(02):79.[doi:10.13798/j.issn.1009-153X.2016.02.006]
　LI Yu-long,FANG Xing-gen,LI Zhen-bao,et al.Endovascular embolization of ruptured paraclinoid aneurysms (report of 26 cases)[J].,2016,(11):79.[doi:10.13798/j.issn.1009-153X.2016.02.006]
[7]胡　骁　周林裕　王　克　邓剑平　赵振伟.支架辅助血管内栓塞前交通动脉破裂动脉瘤的疗效[J].中国临床神经外科杂志,2016,(02):82.[doi:10.13798/j.issn.1009-153X.2016.02.007]
　HU Xiao,ZHOU Lin-yu,WANG Ke,et al.Curative effect of stent-assisted endovascular embolization on ruptured anterior communicating artery aneurysms[J].,2016,(11):82.[doi:10.13798/j.issn.1009-153X.2016.02.007]
[8]申汉威　李俊卿　李红星　汪立刚　杨孔宾.颅内破裂动脉瘤夹闭术与血管内栓塞术后脑积水发生率的比较分析[J].中国临床神经外科杂志,2015,(03):140.[doi:10.13798/j.issn.1009-153X.2015.03.004]
　SHEN Han-wei,LI Jun-qing,LI Hong-xing,et al.Clinical study and Meta-analysis of incidences of hydrocephalus after microsurgery and endovascular embolization in patients with ruptured intracranial aneurysms[J].,2015,(11):140.[doi:10.13798/j.issn.1009-153X.2015.03.004]
[9]王玉贵　李朝晖　郭永川　贾翊平　梁世鹏　刘德华.眶上外侧入路与翼点入路显微手术治疗急性期前循环破裂动脉瘤的对比分析[J].中国临床神经外科杂志,2016,(08):452.[doi:10.13798/j.issn.1009-153X.2016.08.002]
　WANG Yu-gui,LI Chao-hui,GUO Yong-chuan,et al.Microsurgery through lateral supraorbital approach for acute ruptured anterior circulation aneurysms[J].,2016,(11):452.[doi:10.13798/j.issn.1009-153X.2016.08.002]
[10]郎胜坤　许厚银　董月青　马铁柱　孙　艳　郝芊芊　王慧敏.磁共振灌注成像评估蛛网膜下腔出血后脑血管痉挛的价值[J].中国临床神经外科杂志,2016,(09):517.[doi:10.13798/j.issn.1009-153X.2016.09.002]
　LANG Sheng-kuan,XU Hou-yin,DONG Yue-qing,et al.Evaluation of cerebral vasospasm after aneurysmal subarachnoid hemorrhage by magnetic resonance perfusion weighted imaging[J].,2016,(11):517.[doi:10.13798/j.issn.1009-153X.2016.09.002]

更新日期/Last Update: 1900-01-01