摘要
背景:已知血流动力学因素在动脉瘤的发生、发展和破裂中起重要作用。目的:以三维计算机数值模拟观察颅内分叉部动脉瘤的血流动力学特性。设计、时间及地点:三维数值模拟试验,于2008-07在北京神经外科研究所血管内治疗实验室进行。对象:选择2008-04/07首都医科大学附属北京天坛医院神经介入科住院患者2例。病例1,女,37岁,血管造影示左侧前交通动脉瘤(共面的分叉部动脉瘤),右侧大脑前动脉A1段不显影。病例2,女,61岁,血管造影示基底动脉顶端动脉瘤(不共面的分叉部动脉瘤)。方法:利用临床三维血管造影图像建立动脉瘤数值模型,并在GE公司的专用工作站进行三维重建。调整重建后的血管图像,并对其进行重新切片。然后运行Matlab7.0软件及自写程序,逐渐生成动脉瘤的STL文件。导入网格生成软件,生成动脉瘤的三维网格。定义边界条件及提取血压波后,应用Fluent软件进行动脉瘤数值模拟。主要观察指标:动脉瘤流入道、流出道、瘤顶部的血流速度、动压及壁面切应力。结果:两个分叉部动脉瘤流入道的血流速度、动压及壁面切应力均最高,瘤顶部最低,与流出道相比较差异有显著性意义(P<0.05);但共面的分叉部动脉瘤瘤顶部的动压较高,平均动压为(62.3853±35.0765)Pa;不共面的分叉部动脉瘤瘤顶部壁面切应力较低,平均壁面切应力为(0.2207±0.0716)Pa。结论:瘤内动压在共面的分叉部动脉瘤破裂因素中起主要作用,而壁面切应力不足是不共面分叉部动脉瘤破裂的主要原因。
BACKGROUND： It is proved that hemodynamic factor plays an important role in the process of initiation, growth and disruption of aneurysm.
OBJECTIVE： To observe the hemodynamic characteristics of intracranial bifurcation aneurysms which located in the bifurcation area by three-dimension computer numerical simulation method.
DESIGN, TIME AND SETTING： Numerical simulation of three-dimension test was performed in the Endovascular Therapy Laboratory of Beijing Neurosurgical Institute in July of 2008.
PARTICIPANTS： Two inpatients from Department of Neural Intervention, Beijing Tiantan Hospital of Capital University of Medical Sciences from April to July were selected. Case 1： Female, 37-year-old with anterior communicating artery aneurysm （coplanar bifurcating aneurysm）, nonvisualization of anterior cerebral artery in A 1 segment. Case 2： Female, 61-year-old with basilar artery apex aneurysm （non-coplanar bifurcating aneurysm）.
METHODS： Aneurysm numerical model was constructed by three-dimensional angiography images, and reconstructed at the special work station of GE Company. The adjusted images were handled by the Matlab7.0 to generate STI file which further introduced into mesh generation software to obtain the three-D meshes of aneurysms. Then the computational fluid dynamics software （Fluent 6.0） was used to simulate the blood flow and analyze the hydrodynamics.
MAIN OUTCOME MEASURES： The blood flow rate in inflow tract, outflow tract and top of aneurysm, dynamic pressure, as well as wall shear stress were observed.
RESULTS： The hemodynamic factors such as velocity, dynamic pressure and wall shear stress were the highest near the inflow tract, and lowest on the top of the aneurysm dome, there had significance compared with outflow tract （P 〈 0.05）. But the dynamic pressure on the top of the coplanar aneurysm was higher with （62.385 3±35.076 5） Pa. The wall shear stress on the top of the non-coplanar aneurysm was lower with （0.220 7±0.071 6） Pa.
CONCLUSION
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第44期8644-8648,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
国家自然科学基金资助项目(30772234)
北京市自然科学基金资助项目(7072016)
北京市优秀人才培养资助个人项目(20061D0300400072)
首都医科大学基础临床合作课题资助项目(2007JL39)~~
