摘要
目的应用计算流体力学(CFD)方法分析不同类型未破裂颅内动脉瘤在血流导向装置(FD)治疗前后的血流动力学变化, 为进一步建立未破裂动脉瘤精准治疗和预后评估方法奠定研究基础。方法纳入空军军医大学第一附属医院神经外科自2022年1月至2022年3月收治的接受FD治疗的不同类型未破裂颅内动脉瘤患者4例, 收集患者术前和术后即刻数字减影血管造影(DSA)资料, 通过三维重建、有限元模拟和CFD方法测算动脉瘤形态学和血流动力学参数, 包括动脉瘤颈口比(OsR)、颈比(NR)、面积比(ArR)、体积比(VoR)、壁面剪切应力(WSS)、标准化壁面剪切应力(NWSS)、血流流入量、相对流入量、动脉瘤平均流速、载瘤动脉平均流速、标准化流速、残余血流体积(RFV)以及入流集中指数(ICI), 并比较治疗前后差异。结果 6枚动脉瘤的OsR分别为0.225、0.267、0.265、0.389、1.000、1.000;NR分别为1.220、0.274、1.090、1.587、2.809、4.019;ArR分别为0.608、0.224、0.623、3.462、1.225和1.784;VoR分别为0.386、0.052、0.212、3.462、0.422和1.882。FD植入后动脉瘤WSS、NWSS、血流流入量、相对流入量、动脉瘤平均流速、载瘤动脉平均流速、标准化流速、RFV以及ICI等参数均显著降低。结论在三维重建结合FD/弹簧圈虚拟植入的基础上, 基于CFD的血流动力学分析可以获得不同类型颅内动脉瘤FD治疗前后的精准参数。
Objective To analyze the hemodynamic changes of different types of unruptured intracranial aneurysms before and after flow diverter(FD)treatment with computational fluid dynamics(CFD),and lay research foundation for precision treatment and prognosis evaluation for unruptured intracranial aneurysmsM.Iethods Four patients with different types of unruptured intracranial aneurysms,admitted to Department of Neurosurgery,First Affiliated Hospital of Air Force Medical University from January 2022 to March 2022,were chosen.Digital subtraction angiography(DSA)data of the patients before and immediately after surgery were collected.Morphological and hemodynamic parameters of the aneurysms were calculated by 3D reconstruction,finite element simulation,and CFD methods:ostium ratio(OsR),neck ratio(NR),area ratio(ArR),volume ratio(VoR),wall shear stress(WSS),normalized wall shell stress(NWSS),blood inflow,relative inflow,aneurysm average velocity,parent artery average velocity,normalized velocity,residual flow volume(RFV),and inflow concentration index(ICI);differences of these indexes before and after treatment were compared.Results The OsR of 6 aneurysms was 0.225,0.267,0.265,0.389,1.000,1.000,respectively;NR was 1.220,0.274,1.090,1.587,2.809,and 4.019,respectively;ArR was 0.608 and 0.224,0.623,3.462,1.225 and 1.784,respectively;and VoR was 0.386,0.052,0.212,3.462,0.422 and 1.882,respectively.The parameters of wSs,NwSS,blood inflow,relative inflow,aneurysm average velocity,parent artery average velocity,normalized velocity,RFV,and ICI decreased obviously after FD implantation.Conclusion On the basis of 3D reconstruction combined with FD/coil virtual implantation,CFDbased hemodynamic analysis can obtain accurate parameters of different types of intracranial aneurysms before and after FD treatment.
作者
张洪晨
谢文宇
冯元
鲁传豪
邵晓东
李亮
吴普丁
雍佳
朱佳文
向建平
李侠
Zhang Hongchen;Xie Wenyu;Feng Yuan;Lu Chuanhao;Shao Xiaodong;Li Liang;Wu Puding;Yong Jia;Zhu Jiawen;Xiang Jianping;Li Xia(Department of Neurosurgery,First Afiliated Hospital of Air Force Medical University,Xi'an 710032,China;Research and Development Department,Artery Flow Technology Co.,Ltd,Hangzhou 310051,China)
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2023年第3期222-230,共9页
Chinese Journal of Neuromedicine
基金
国家自然科学基金(81974188)
陕西省重点研发计划项目(2019SF-032)
陕西省创新能力支撑计划(2022TD42)
空军军医大学军事医学提升计划(2021JSTS03)。
