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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Assessing the Hemodynamics in Residual Cavities of Intracranial Aneurysm after Coil Embolization with Combined Computational Flow Dynamics and Silent Magnetic Resonance Angiography
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Assessing the Hemodynamics in Residual Cavities of Intracranial Aneurysm after Coil Embolization with Combined Computational Flow Dynamics and Silent Magnetic Resonance Angiography

机译：用组合计算流动动力学和沉默磁共振血管造影螺栓栓塞后颅内动脉瘤残余腔内血流动力学

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Background and Purpose: Metal artifacts limit computational fluid dynamics analysis after coil embolization. Silent magnetic resonance angiography reduces metal artifacts and improves visualization of the residual cavity of coil-embolized aneurysms. This study investigated the flow dynamics of the residual cavity after coil embolization using silent magnetic resonance angiography and computational fluid dynamics to elucidate the hemodynamic characteristics of recanalization. Methods: Twenty internal carotid-posterior communicating aneurysm cases treated with coil embolization and without stent assistance were followed up (mean standard deviation, 13.0 +/- 6.1 months) and assessed using silent magnetic resonance angiography. The hemodynamic characteristics of the residual cavities in both types of aneurysms were compared between neck remnants, which persisted for >12 months (NR group), and those treated with coil compaction-induced body filling (BF group). Computational fluid dynamics analysis of each aneurysm was performed using morphological data obtained from silent magnetic resonance angiography. Pressure, pressure difference, normalized wall shear stress, and flow velocity were measured. Results: The residual cavity was well-visualized using silent magnetic resonance angiography and compared with those imaged using conventional time-of-flight magnetic resonance angiography, and eight internal carotid-posterior communicating aneurysms with neck remnants and body filling were investigated. The maximum pressure area was localized to the aneurysm wall in the NR group (n=4) and to sides of the coil surface in the BF group (n=4). No significant differences were observed for each hemodynamic parameter. Conclusions: Combination of silent magnetic resonance angiography and computational fluid dynamics helps to understand the hemodynamic characteristics of residual cavity in coil-embolized aneurysms. The flow-impingement zone at the coil surface (maximum pressure area) may influence the risk for future coil compaction.
机译：背景和目的：金属伪影限制了线圈栓塞后的计算流体动力学分析。无声磁共振血管造影减少了金属伪影，改善了线圈栓塞动脉瘤残余腔的可视化。本研究采用静默磁共振血管造影和计算流体力学方法研究了线圈栓塞后残余腔的流动动力学，以阐明再通的血流动力学特征。方法：对20例颈内动脉后交通动脉瘤患者进行随访（平均标准差13.0+/-6.1个月），并采用无症状磁共振血管造影进行评估。比较两种类型动脉瘤残余腔的血流动力学特征，即颈部残余腔持续时间>12个月（NR组），以及采用弹簧圈压迫诱导充体治疗的残余腔（BF组）。利用静默磁共振血管造影获得的形态学数据对每个动脉瘤进行计算流体动力学分析。测量了压力、压差、标准化壁面剪应力和流速。结果：静息磁共振血管成像能很好地显示残余腔，并与传统的飞行时间磁共振血管成像进行比较，研究了8个颈内动脉后交通动脉瘤的颈部残留和充盈情况。NR组（n=4）的最大压力区位于动脉瘤壁，BF组（n=4）的最大压力区位于线圈表面的两侧。各血流动力学参数均无显著差异。结论：静息磁共振血管造影和计算流体力学相结合有助于了解弹簧圈栓塞动脉瘤残余腔的血流动力学特征。盘管表面的气流冲击区（最大压力区）可能会影响未来盘管压实的风险。

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