基于MRA的大脑中动脉瘤血液流变特性研究  

Investigation on hemorheological characteristics of middle cerebral aneurysm based on MRA

作　　者：樊俊杰[1] 陈广新[2] 郭金兴 张洋 FAN Junjie;CHEN Guangxin;GUO Jinxing;ZHANG Yang(School of Health Management,Mudanjiang Medical University,Heilongjiang,Mudanjiang 157011,China;School of Medical Imaging,Mudanjiang Medical University,Heilongjiang,Mudanjiang 157011,China;Department of Ophthalmology,Hongqi Hospital Affiliated to Mudanjiang Medical University,Heilongjiang,Mudanjiang 157011,China;Department of Clinical Laboratory,the Second Affiliated Hospital of Mudanjiang Medical University,Heilongjiang,Mudanjiang 157011,China)

机构地区：[1]牡丹江医学院卫生管理学院,黑龙江牡丹江157011 [2]牡丹江医学院医学影像学院,黑龙江牡丹江157011 [3]牡丹江医学院附属红旗医院眼内科,黑龙江牡丹江157011 [4]牡丹江医学院附属第二医院检验科,黑龙江牡丹江157011

出　　处：《中国医药科学》2023年第7期20-23,40,共5页China Medicine And Pharmacy

基　　金：黑龙江省省属高等学校基本科研业务费科研项目(2020-KYYWFMY-0057)。

摘　　要：目的基于磁共振血管成像(MRA)的大脑中动脉瘤(MCAA)血液流变特性研究,总结大脑中动脉瘤血流动力学特征,为临床治疗提供借鉴。方法收集2018年3月至2019年12月牡丹江医学院附属红旗医院诊断为MCAA及正常大脑中动脉的MRA,以大脑中动脉MRA图像为基础构建动脉三维几何模型,分为动脉瘤组与对照组,每组各15例,应用计算流体力学方法对血管进行数值模拟分析。结果获得了大脑中动脉瘤模型的血流动力学参数,数值模拟结果显示血流速度、壁面压力(WP)及震荡剪切系数(OSI)均高于对照组,差异有统计学意义(P<0.05)。大脑中动脉瘤组瘤体内血流紊乱,表现为低速涡流状态;动脉瘤组左侧颈内动脉至瘤颈前部血管表现为高WP,双侧颅内血管血流速度及壁压不对称;动脉瘤组内OSI变化显著,可见瘤体、瘤颈部散在分布小片状、团块状高OSI区域,同时双侧大脑前动脉、前交通动脉可见OSI局部波动。结论大脑中动脉瘤体内表现为血流紊乱、高壁面压力及高OSI波动,提高血管壁损伤概率及加快瘤体破裂进程,增大了动脉瘤破裂的风险。Objective To investigate the hemorheological characteristics of middle cerebral artery aneurysm based(MCAA)on magnetic resonance angiography(MRA)and summarize the hemodynamic characteristics of middle cerebral aneurysm,so as to provide reference for clinical treatment.Methods The MRA of MCAA and normal middle cerebral artery diagnosed by Hongqi Hospital Affiliated to Mudanjiang Medical University was collected from March 2018 to December 2019.Based on MRA images of the middle cerebral artery,a three-dimensional geometric model of the artery was constructed.The images were divided into the aneurysm group(n=15)and the control group(n=15).The computational fluid dynamics method was used to conduct numerical simulation analysis for the blood vessels.Results The hemodynamic parameters of the middle cerebral aneurysm model were obtained.The numerical simulation results showed that the three indices of blood flow velocity,wall pressure and oscillatory shear stress(OSI)were all higher than those of the control group,with statistically significant differences(P<0.05).In the middle cerebral aneurysm group,the blood flow in the tumor was turbulent,showing a low-speed vortex state;In the aneurysm group,the left internal carotid artery to the anterior part of the aneurysm neck showed high wall pressure,and the blood flow velocity and wall pressure of bilateral intracranial vessels were asymmetric.In the aneurysm group,OSI changes were significant.The tumor body and tumor neck were scattered in small flaky and lumpy areas with high OSI.Simultaneously,the local fluctuation of OSI was found in bilateral anterior cerebral arteries and anterior communicating arteries.Conclusion The middle cerebral aneurysm is characterized by blood flow disorder,high wall pressure and high OSI fluctuation in vivo,which increases the probabilities of vascular wall injury and accelerates the process of tumor rupture,thus increasing the risk of aneurysm rupture.

关 键 词：大脑中动脉瘤 血流动力学 紊流 瘤体破裂 

分 类 号：R743[医药卫生—神经病学与精神病学]