Objective To examine relationship between the morphology of intracranial aneurysm and hemodynamics.Methods Twenty-two patients with intracranial aneurysms(22 aneurysms) admitted in Shaoxing People's Hospital January-June 2015 were included in the study.Computational fluid dynamics was used to determine the distribution of wall shear stress (WSS) and its ratio of parent vessel,the degree of concentration of the wall shear stress distribution.Two-dimensional (2D) variables were measured by Digital Signature Algorithm (DSA),including maximum neck diameter,minimum neck diameter,height,aneurysm width,parent diameter,maximum neck diameter/parent diameter,minimum neck diameter/parent diameter and aneurysm angle.The correlation between hemodynamics and morphology of intracranial aneurysm was analyzed.Results The ratio of minimum neck width or maximum neck width and parent artery was correlated with WSS (P＜ 0.05).The ratio of the maximum neck width and parent artery and aneurysm WSS conformed to linear regression model(P=0.006).The ratio of the maximum neck width and parent artery and WSS ratio conformed to linear regression model (,=0.031).The angle between aneurysms and parent artery was correlated with shear concentration index(SCl)(r=0.452,P＜0.05).The aneurysm angle conformed to linear regression model (P=0.035).All aneurysms were divided into three groups according to ratio of the maximum neck width and parent artery (＜1,1～2,＞2).WSS of aneurysms with ratio of the maximum neck width and parent artery＞2 was significantly higher than ＜ 1 group and1～2 group(P＜0.05).WSS ratio of aneurysms with ratio of the maximum neck width and parent artery ＞2 was significantly higher than ＜ 1 group and 1～2 group (P＜0.05).Hemodynamics demonstrated that SCl of aneurysms with greater aneurysm angle (＞135 degree) was significantly higher than ones with smaller angle(＜135 degree)(P=0.021).Conclusion Aneurysm morphology and its geometrical relation to the parent artery affect the distribution and magnitude of WSS on the basis of differences in blood flow.Mean WSS is affected by the maximum neck width and parent artery diameter.Degree of concentration of the wall shear stress is affected by angle of aneurysms and parent artery.%目的 探讨颅内动脉瘤形态与血流动力学的关系.方法 采用计算流体力学软件测量22个动脉瘤的壁面剪应力(WSS)、WSS比值、剪应力集中指数(SCI),同时在DSA上测量动脉瘤的二维参数(最大瘤颈、最小瘤颈、动脉瘤高度、动脉瘤横径、载瘤动脉直径、最大瘤颈/载瘤动脉直径、最小瘤颈/载瘤动脉直径、动脉瘤角度),比较并分析颅内动脉瘤形态指标与血流动力学指标的关系.结果 最大瘤颈/载瘤动脉直径、最小瘤颈/载瘤动脉直径与动脉瘤WSS、WSS比值均呈正相关(r动脉瘤WSS=0.565、0.481,rWSS比值=0.461、0.454,均P＜0.05),动脉瘤角度与SCI呈正相关(r=0.452,P＜0.05).血流动力学指标的逐步回归方程如下:动脉瘤WSS=-55.99+88.99 ratio1(P=0.006),WSS比值=0.048+0.264 ratio1(P=0.031),SCl=-0.691+0.097 angle(P=0.035);式中ratio1为最大瘤颈/载瘤动脉直径,angle为动脉瘤角度.按最大瘤颈/载瘤动脉直径分为＜1组、1～2组、＞2组,3组动脉瘤WSS、WSS比值差异均有统计学意义(均P＜0.05),其中＞2组均明显高于＜1组、1～2组(均P＜0.05);瘤颈/载瘤动脉直径较大的动脉瘤,其WSS较高,反之较低.按载瘤动脉角度分为＜135°组、≥135°组,两组SCI比较差异有统计学意义(P＜0.05).结论 血流动力学是由动脉瘤形态以及其与载瘤动脉的关系所决定,WSS与最大瘤颈/载瘤动脉直径有关,SCI与动脉瘤角度有关.
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