摘要
目的应用四维血流磁共振成像(4D-FLOW MRI)技术,研究颅内囊状动脉瘤及瘤颈周围载瘤动脉内血流动力学变化特征。方法经头颅CT血管造影(CTA)或磁共振血管造影(MRA)诊断为颅内囊状动脉瘤患者68例;应用4D-FLOW技术扫描并重建后进行血流动力学分析。在载瘤动脉的囊状动脉瘤入口截面处、囊状动脉瘤沿血流方向最大截面处、囊状动脉瘤出口截面处以及对侧动脉的对称位置分别手动勾画血管边缘轮廓,自动获取血流动力学参数。采用配对t检验比较载瘤动脉与对侧动脉之间的血流动力学参数。根据囊状动脉瘤最大径和尺寸比(SR)分组,采用独立样本t检验分析不同分组载瘤动脉血流动力学参数的差异。结果载瘤动脉与对侧动脉比较,颅内囊状动脉瘤入口截面最大壁剪切应力(WSS)、平均WSS、最大轴向WSS-最大周向WSS小于对侧对称截面;囊状动脉瘤沿血流方向最大截面处最大WSS、平均WSS、平均轴向WSS、平均轴向WSS-平均周向WSS在载瘤动脉中较小,载瘤动脉中的最大能量损失和平均能量损失显著高于对侧动脉,上述差异均具有统计学意义(P<0.05)。在载瘤动脉中最大径>5 mm组的囊状动脉瘤入口截面最大轴向WSS和平均轴向WSS大于最大径≤5 mm组;与SR≤2组对比,SR>2组囊状动脉瘤入口截面平均轴向WSS更大,差异均具有统计学意义(P<0.05)。结论应用4D-FLOW MRI技术可动态显示颅内囊状动脉瘤及瘤颈周围载瘤动脉内的血流环境,量化评估血流动力学特征,在探索颅内囊状动脉瘤形成因素中具有重要价值。
Objective This study aims to investigate hemodynamic alterations in saccular intracranial aneurysms and their adjacent arteries using four-dimensional flow magnetic resonance imaging(4D-FLOW MRI).Methods We enrolled 68 patients diagnosed with intracranial aneurysms through CT angiography and head MR angiography at Wuhan Union Hospital.Hemodynamic analyses were conducted after 4D-FLOW MRI scanning and reconstruction,and the hemodynamic parameters were automatically derived through the manual delineation of vessel contours at various critical locations within the parent artery.These locations included the aneurysm inlet cross-section,the aneurysm's largest cross-section in alignment with the blood flow direction,the aneurysm outlet cross-section,and symmetrical positions corresponding to the contralateral arteries.Paired-sample t-test was employed to compare hemodynamic parameters between the parent artery and the contralateral artery.According to the grouping based on the maximum diameter and size ratio(SR)of saccular aneurysms,an independent sample t-test was employed to analyze the differences in hemodynamic parameters of the parent arteries among different groups.Results In the parent artery compared with the contralateral artery,the maximum WSS,mean WSS,and maximum axial WSS-maximum circumferential WSS at the entrance of the intracranial aneurysm were smaller than those in the contralateral symmetrical cross section;the maximum WSS,mean WSS,mean axial WSS,and mean axial WSS-maximum circumferential WSS at the largest cross section of the aneurysm along the direction of blood flow were smaller in the parent artery,and maximum energy loss and mean energy loss were significantly higher in the contralateral arteries,and all these differences were statistically significant(P<0.05).In the parent arteries,the maximum axial WSS and mean axial WSS of the aneurysm inlet section was bigger in the group with a maximum diameter of>5 mm than in the group with a maximum diameter of≤5 mm,and the mean axial WSS of the aneurysm inlet section was greater in the SR>2 group compared with that of the SR≤2 group,and the differences between the groups were statistically significant(P<0.05).Conclusion The application of 4D-FLOW MRI can dynamically display the flow environment in the intracranial saccular aneurysm and the parent artery around the aneurysm neck,and quantitatively evaluate the hemodynamic characteristics,which is of great value in exploring the formation factors of intracranial saccular aneurysms.
作者
桂玉熙
谢铭飞
罗昆
龙茜
郑传胜
GUI Yuxi;XIE Mingfei;LUO Kun(Department of Radiology,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei Province 430022,P.R.China)
出处
《临床放射学杂志》
北大核心
2024年第1期6-12,共7页
Journal of Clinical Radiology
基金
国家自然科学青年基金项目(编号:82102153)。
