颅内大型动脉瘤血流动力学特点分析  

Hemodynamic analyses of large intracranial aneurysms

作　　者：吴京[1] 刘爱华[1] 符策基[2] 赵艺[2] 钱增辉[1] 康慧斌[1] 彭汤明[1] 吴中学[1] 

机构地区：[1] 北京市神经外科研究所, 首都医科大学附属北京天坛医院,100050 [2] 北京大学工学院力学与工程科学系

出　　处：《中华医学杂志》2014年第25期1921-1924,共4页National Medical Journal of China

基　　金：国家自然科学基金（30901557）;北京市自然科学基金（7142032）;北京市高层次卫生人才项目（2011-3-036）;北京市科技新星计划（2007A043）;北京市科技新星交叉学科合作课题（Z14111000180000）

摘　　要：目的：应用血流动力学数值模拟技术，分析不同类型颅内大型动脉瘤的血流动力学特点。方法根据出流血管与主要涡流平面的相对位置及入射血流冲击域位置，将颅内大型动脉瘤分为A （出流血管与主要涡流平面共面）、B1（出流血管与主要涡流平面不共面，冲击域位于一侧瘤壁）及B2（出流血管与主要涡流平面不共面，冲击域位于瘤顶）3类。应用计算流体力学软件对各型颅内动脉瘤进行血流动力学数值模拟运算及分析。结果 A、B1及B2型动脉瘤瘤体与载瘤动脉血流速度比值分别为0.186±0.019、0.706±0.077、0.208±0.041，剪切力比值分别为0.081±0.029、1.019±0.139、0.103±0.031。 A型动脉瘤血流速度、瘤壁剪切力水平低于B型动脉瘤，B1型动脉瘤瘤顶、瘤体的血流速度、剪切力水平高于B2型动脉瘤，差异均有统计学意义（均P＜0.05）。结论颅内大型动脉瘤出流血管相对位置和入射血流方向会影响瘤体内血液流动水平。Objective To simulate the computational hemodynamics of large intracranial aneurysms and analyze the hemodynamics of three types of large intracranial aneurysms .Methods A total of 32 patient-specific models of large intracranial aneurysms were constructed with the data of DSA （ digital subtraction angiography ）.According to the location of outflow vessel , plane of main vortex and impact zone , large intracranial aneurysms were classified into type A （ outflow vessel in the plane of main vortex ） , type B1 （ outflow vessel out of plane of main vortex , impact zone at the lateral wall of aneurysm ） and type B2 （ outflow vessel out of plane of main vortex , impact zone at the dome of aneurysm ）.Blood flow was assumed to be laminar and incompressible and blood Newtonian fluid.The time-dependent pulsatile boundary condition was deployed at inlet.CFD ICEM and Fluent software packages were used to simulate the computational hemodynamics of large intracranial aneurysms .Results The distributions of hemodynamic variables during the cardiac cycle were analyzed for wall shear stress , velocity and streamlines.The velocity ratio （ ratio of aneurysmal flow velocity to parent artery flow velocity ） of type A, B1 and B2 was 0.186 ± 0.019, 0.706 ±0.077 and 0.208 ±0.041 respectively.The wall shear stress ratio （ratio of aneurysmal wall shear stress to parent artery wall shear stress ） of types A, B1 and B2 was 0.081 ±0.029, 1.019 ±0.139 and 0.103 ±0.031 respectively.The flow velocity and wall shear stress were the highest in type B 1 group, followed by those in type B2 group and the lowest in type A group .Conclusion As reflected by the location of impact zone , the location of outflow vessel and inflow-angle can influence the level of blood flow in aneurysm sac .

关 键 词：颅内动脉瘤 血流动力学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]