基于影像数据的三维颅内动脉瘤血流动力学数值：手术前后壁面切模拟对比

3D hemodynamic numerical simulation of intracranial aneurysms before and after embolism treatment based on image data

背景:颅内动脉瘤是由于动脉血管壁病理性局限性扩张产生的脑血管瘤样突起。血流动力学因素被认为是颅内动脉瘤形成、生长、破裂过程中的一个重要因素,因此基于计算流体力学的计算机数值模拟技术得到了广泛的应用。目的:通过对颅内动脉瘤术前术后进行血流动力学分析计算,探讨颅内动脉瘤术后壁面切应力的变化对动脉瘤是否复发的影响。方法:对1例复发病例和1例未复发病例术前、术后的动脉瘤进行建模,实行血流动力学计算。结果与结论:复发病例术后动脉瘤残颈处的切应力局部剧增;未复发病例术后动脉瘤残颈处切应力普遍减小。术后动脉瘤残颈处壁面切应力与术前相比,若普遍减小,能够降低动脉瘤复发的风险;反之,则增大了动脉瘤复发的风险,动脉瘤易复发。

BACKGROUND：Intracranial aneurysms are pathological dilatations of the arterial wall. Hemodynamic factors play an important role in the formation,growth and rupture of intracranial aneurysms. Therefore,the computational numerical simulation technique based on computational fluid hydrodynamics has been used widely in this field. OBJECTIVE：To explore the relationship between the change of the wall shear stress before and after treatment and recrudescence of intracranial aneurysms. METHODS：3-D models of intracranial aneurysms were created based on patient-specific anatomical images and performed hemodynamic numerical simulation of the models of two patients before and after embolism treatment. RESULTS AND CONCLUSION：For the recrudescent case,the wall shear stress at the neck of the aneurysm was considerably greater than before treatment. While,for the unrecrudescent case,the wall shear stress at the neck of the aneurysm was lower than before treatment. If the wall shear stress at the neck of the aneurysm is lower than before treatment,the risk of recrudescence is low; otherwise,the risk of recrudescence is high.