颅内动脉瘤壁切应力与动脉瘤破裂关系的初步研究——基于患者的三维计算机模拟  

Correlation between wall shear stress and the rupture of saccular intracranial aneurysms:the initial experimental results with patient-specific 3-D computational model

作　　者：鲁刚[1] 黄磊[1] 张晓龙[1] 王盛章[2] 万军 洪泳[1] 胡宙[1] 耿道颖[1] 

机构地区：[1]复旦大学华山医院放射科,上海200040 [2]复旦大学力学与工程科学系 [3]静安区中心医院介入科

出　　处：《介入放射学杂志》2009年第8期568-571,共4页Journal of Interventional Radiology

基　　金：国家自然科学基金资助项目(30870707);上海市科委科研计划资助项目(064119609)

摘　　要：目的通过比较颅内无症状动脉瘤和症状动脉瘤的血流动力学参数,寻找与动脉瘤破裂有关的血流动力学因素。方法5例患者DSA检查共发现8个颈内动脉动脉瘤,分别位于颈内动脉后交通段及颈眼动脉段。通过旋转DSA,重建动脉瘤三维模型,并使用有限体积法进行血流动力学数值模拟,比较不同组动脉瘤及载瘤动脉的血流动力学参数。两组数据对比时采用独立样本t检验,瘤颈与载瘤动脉比较使用配对t检验。结果无症状组和症状组动脉瘤瘤颈部平均切应力分别为(5.54±2.89)Pa和(4.78±3.84)Pa,两组间差异无统计学意义(P=0.78);动脉瘤临近载瘤动脉平均切应力分别为(6.6±3.47)Pa和(7.30±3.80)Pa,两组间差异无统计学意义(P=0.80);动脉瘤低切应力区域的大小分别为0.33%和4.72%,两组间差异有统计学意义(P=0.01)。结论动脉瘤壁低切应力区域的大小可能是影响颅内囊状动脉瘤破裂的因素之一。Objective To find out the hemodynamic factors relating to the rupture of intracranial aneurysm by comparing the hemodynamie parameters of the asymptomatic intracranial aneurysms with that of symptomatic ones. Methods Eight intracranial aneurysms in five patients were discovered on DSA. By using rotational DSA, 3-D models of the intracranial aneurysms were established, and the numerical simulation of the hemodynamics parameters was performed with finite volume method. The hemodynamics parameters between the aneurysms and the parent arteries were statistically analyzed and compared. Results The average shear stress of the neck and the close parent artery in asymptomatic group was （5.54 ± 2.89） Pa and （6.6 ± 3.47） Pa respeetively, while it was （4.78 ± 3.84） Pa and （7.30 ± 3.80） Pa respectively in symptomatic group. No significant difference in the average shear stress of both the aneurysmal neck and its close parent artery existed between two groups （P 〈 0.05）. The low shear stress region of asymptomatic group and symptomatic group was （0.33±0.57）% and （4.72 ± 5.31）% respectively, with a significant difference between the two （P 〈 0.05）. Conclusion The size of low shear stress region of aneurysmal wall may be one of the main factors causing the rupture of the saccular intracranial aneurysms.

关 键 词：颅内动脉瘤 计算机流体力学 侧壁切应力 

分 类 号：R743.4[医药卫生—神经病学与精神病学]