子囊型后交通动脉动脉瘤血流动力学和形态学的计算机数值模拟分析  

Computer numerical simulation analysis of hemodynamics and morphology of daughter bleb type posterior communicating artery aneurysm

作　　者：袁金龙[1] 方兴根[1] 李真保[1] 赵心同[1] 吴德刚[1] 赖年升[1] 刘佳强[1] 徐善水[1] 

机构地区：[1]皖南医学院附属弋矶山医院神经外科,安徽省芜湖市241001

出　　处：《中国脑血管病杂志》2016年第6期313-317,共5页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的应用计算机数值模拟技术探讨子囊型破裂与未破裂后交通动脉动脉瘤(PCo A-AN)的血流动力学和差异。方法回顾性收集2015年1月至12月在皖南医学院附属弋矶山医院神经外科通过全脑DSA诊断为子囊型PCoA-AN 31个,其中破裂动脉瘤20个,未破裂动脉瘤11个。重组三维DSA动脉瘤模型,并应用计算流体力学方法分析PCoA-AN的血流动力学特征,并应用Matlab软件计算形态学的相关参数。结果破裂组动脉瘤平均壁面切应力(WSS)明显低于未破裂组[(11.8±1.3)Pa比(13.8±1.0)Pa,P=0.02]。破裂组低WSS面积比值(LSA)明显高于未破裂组[中位数为9.0(8.2,10.2)比3.1(2.3,3.2),P<0.01]。两组间的剪切振荡指数、归一化WSS、纵横比、大小比、椭圆形指数、波动指数及非球面指数差异均无统计学意义(均P>0.05)。结论低WSS和高LSA可能是导致子囊型PCo A-AN破裂的原因。Objective To investigate the hemodynamie differences of daughter bleb type ruptured and unruptured posterior communieating artery aneurysms using computer numerical simulation technology. Methods Thirty-one daughter bleb type posterior communicating artery aneurysms （PCoA-AN） were diagnosed with whole brain DSA at the Department of Neurosurgery, Yijishan Hospital, Wannan Medieal College from January to December 2015 were collected retrospectively, including 20 ruptured aneurysms and 11 urtruptured ones. A three dimensional DSA aneurysm model was reeombined,and the hemodynamie charac- teristics of PCoA-AN were analyzed by using the computational fluid dynamics. Madab software was used to calculate the related parameters of computational morphology. Results The mean wall shear stress （WSS） of the ruptured aneurysm group was significantly lower than that of the unruptured aneurysm group （ 11.8±1.3 vs. 13.8±1.0, P = 0.02 ）. The ratio of the low wall shear stress area （ LSA ） of ruptured aneurysm group was sigrfifieantly higher than that of the unruptured aneurysm group （they were 9.0 [ 8.2,10.2 ] vs. 3.1 [2.3,3.2] respeetively,P 〈0.01 ）. There were no significant differences in the shear oscillation index, normalized WSS, aspect ratio, size ratio, elliptic index, pulsatility index, and non-spherical index between the two groups （ all P 〉 0.05 ）. Conclusion Low WSS and high LSA may be the causes of resuhing in the rupture of daughter bleb type PCoA-AN.

关 键 词：颅内动脉瘤 血流动力学 形态学 后交通动脉动脉瘤 子囊型 

分 类 号：R743[医药卫生—神经病学与精神病学]