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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 hemodynamics and differences of PCo A-aneurysms after ascranial rupture and unruptured by computer numerical simulation. Methods A total of 31 ascocytic PCoA-AN were diagnosed in Department of Neurosurgery, Yijishan Hospital Affiliated to Wannan Medical College from January to December 2015, including 20 ruptured aneurysms and 11 unruptured aneurysms. The three-dimensional DSA aneurysm model was reconstructed and the hemodynamic characteristics of PCoA-AN were analyzed by computational fluid dynamics. The morphological parameters were calculated by Matlab software. Results The mean wall shear stress (WSS) of aneurysm in ruptured group was significantly lower than that in ruptured group [(11.8 ± 1.3) Pa vs (13.8 ± 1.0) Pa, P = 0.02]. The low WSS area ratio (LSA) in the ruptured group was significantly higher than that in the unruptured group [median 9.0 (8.2,10.2) vs 3.1 (2.3,3.2), P <0.01]. Shear oscillation index, normalized WSS, aspect ratio, size ratio, elliptical index, wave index and aspheric index had no significant difference between the two groups (all P> 0.05). Conclusions Low WSS and high LSA may be responsible for the ruptured PCo A-AN.