不同栓塞程度对颅内动脉瘤介入治疗后囊内血流动力学影响的数值模拟研究  

Impact of different coil packing densities on intra-aneurysmal hemodynamics during embolization of intracranial aneurysm:a numerical simulative study

作　　者：吴永发[1] 沈洁[1] 黄清海[1] XIANG Jian-ping MENG Hui 刘建民[1] 

机构地区：[1]第二军医大学长海医院临床神经医学中心、神经外科,上海200433 [2]Toshiba Stroke Research Center, University at Buffalo, State University of New York, Buffalo, New York 14620, USA

出　　处：《第二军医大学学报》2012年第2期195-199,共5页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(81171092)~~

摘　　要：目的研究弹簧圈栓塞不同栓塞程度下颅内动脉瘤内血流动力学变化,为临床血管内治疗策略的制定提供理论依据。方法基于脑动脉瘤血管造影的三维血管成像,在不同栓塞状态下,重建动脉瘤的三维模型,采用Ansys CFX软件包分析血流速度、壁面切应力(WSS)、压力分布和流场情况。结果与治疗前相比,动脉瘤顶端部分栓塞后瘤体明显缩小,瘤顶低WSS区域减小,瘤体内涡流减少但流速无变化,同时造成瘤顶部平均WSS增大为2.13 Pa;而继续栓塞后,使动脉瘤整体壁面切应力显著下降,残留瘤颈远端流速明显降低;无论栓塞与否,动脉瘤流入道血管壁的壁面压力均无明显变化。结论颅内动脉瘤囊内血流动力学变化受弹簧圈栓塞程度及其在瘤体内分布的影响。Objective To investigate the impact of different coil packing densities on intra-secular hemodynamics during embolization of intracranial aneurysm,so as to provide the theoretical evidence for endovascular treatment of intracranical aneurysms.Methods Based on digital subtraction angiography image data,the vessel numerical models with different packing densities were constructed using computational fluid dynamics software.The hemodynamic parameters,including the wall shear stress（WSS） and flow steamline and pressure,were obtained from the numerical simulation using Ansys CFX software.Results The aneurysm volume and low WSS area in the aneurysm sac were decreased after the first session of embolization compared with before treatment;the vortex in the aneurysm was decreased and the aneurysmal flow velocity had no significant changes.Meanwhile,the WSS at the aneurysm dome increased to 2.13 Pa.Continuous embolization greatly decreased the overall aneurysmal flow velocity and the aneurysmal flow velocity at the distal part of the residual aneurysm neck.The average wall pressure of the inflow tract had no noticeable changes before and after embolization.Conclusion The intra-saccular hemodynamics during embolization of intracranial aneurysm can be influenced by the coil packing density and coil distribution in the aneurysm.

关 键 词：颅内动脉瘤 介入治疗 治疗性栓塞 血流动力学 

分 类 号：R743[医药卫生—神经病学与精神病学]