中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (11): 1007-1015.doi: 10.3969/j.issn.1673-5374.2013.11.006

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

颅内动脉瘤及周围血管的壁剪切力

  

  • 收稿日期:2012-12-21 修回日期:2013-03-07 出版日期:2013-04-15 发布日期:2013-04-15

Wall shear stress in intracranial aneurysms and adjacent arteries

Fuyu Wang1, Bainan Xu1, Zhenghui Sun1, Chen Wu1, Xiaojun Zhang2   

  1. 1 Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
    2 College of Mechanical Engineering and Applied Electronics Technology, Beijing University of Technology, Beijing 100124, China
  • Received:2012-12-21 Revised:2013-03-07 Online:2013-04-15 Published:2013-04-15
  • Contact: Bainan Xu, M.D., Ph.D., Chief physician, Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China, shjwkk@sina.com.
  • About author:Fuyu Wang☆, M.D., Attending physician.
  • Supported by:

    国家自然科学基金(No.81171109)

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摘要：

血流动力学在动脉瘤的发生及生长起着重要的作用，以往研究者在临床上很难直接观察到快速增长的新发动脉瘤。为了观察血流动力学与颅内动脉瘤发生和生长之间的关系，实验基于CT血管成像数据重建1例多发动脉瘤(包括1个颈内动脉瘤和1个前交通动脉瘤)的模型，通过将前交通动脉瘤移除以建立模拟前交通动脉瘤发生的模型，在此基础上再先后2次缩小颈内动脉瘤以建立模拟颈内动脉瘤生长的模型，然后进行血流动力学分析，分析并比较了模型之间壁剪切力。结果显示，在颈内动脉瘤生长模型中，随着颈内动脉瘤瘤体的增大，低壁剪切力区域随之增大，动脉瘤顶部壁剪切力明显降低，载瘤动脉的壁剪切力也发生显著变化；前交通动脉的壁剪切力持续处于低值状态，并且显著低于颈内动脉分叉和大脑中动脉分叉处；在前交通动脉瘤形成后，颈内动脉瘤顶端的壁剪切力显著增加，且其上游载瘤动脉的壁剪切力也发生明显变化。说明低壁剪切力与动脉瘤的发生和生长相关，同时动脉瘤的发生和生长也会影响局部和附近血管的血流动力学变化。

关键词: 神经再生, 脑损伤, 壁剪切力, 血流动力学, 颅内动脉瘤, 流固耦合模型, 生长, 形成, CT血管成像, 二次建模, 多发动脉瘤, 数值模拟, 基金资助文章

Abstract:

Hemodynamic parameters play an important role in aneurysm formation and growth. However, it is difficult to directly observe a rapidly growing de novo aneurysm in a patient. To investigate possible associations between hemodynamic parameters and the formation and growth of intracranial aneurysms, the present study constructed a computational model of a case with an internal carotid artery aneurysm and an anterior communicating artery aneurysm, based on the CT angiography findings of a patient. To simulate the formation of the anterior communicating artery aneurysm and the growth of the internal carotid artery aneurysm, we then constructed a model that virtually removed the anterior communicating artery aneurysm, and a further two models that also progressively decreased the size of the internal carotid artery aneurysm. Computational simulations of the fluid dynamics of the four models were performed under pulsatile flow conditions, and wall shear stress was compared among the different models. In the three aneurysm growth models, increasing size of the aneurysm was associated with an increased area of low wall shear stress, a significant decrease in wall shear stress at the dome of the aneurysm, and a significant change in the wall shear stress of the parent artery. The wall shear stress of the anterior communicating artery remained low, and was significantly lower than the wall shear stress at the bifurcation of the internal carotid artery or the bifurcation of the middle cerebral artery. After formation of the anterior communicating artery aneurysm, the wall shear stress at the dome of the internal carotid artery aneurysm increased significantly, and the wall shear stress in the upstream arteries also changed significantly. These findings indicate that low wall shear stress may be associated with the initiation and growth of aneurysms, and that aneurysm formation and growth may influence hemodynamic parameters in the local and adjacent arteries.

Key words: neural regeneration, wall shear stress, hemodynamic parameters, intracranial aneurysm, fluid-solid coupled model, growth, formation, CT angiography, second reconstruction, multiple aneurysms, numerical simulation, grants-supported paper, neuroregeneration