颅内未破裂与破裂动脉瘤血流动力学数值模拟研究

目的应用数值模拟，研究配对颅内术破裂与破裂动脉瘤的血流动力学差异，得出颅内破裂动脉瘤的血流动力学特征。方法选择动脉瘤形态及一般情况相似的颅内未破裂动脉瘤患者（未破裂组）和破裂动脉瘤患者（破裂组）各12例，以三维旋转造影资料进行数值模型的建立，并进行血流动力学特征的分析及比较，主要包括动脉瘤最大壁面切应力、射入流最大流速及宽度、冲击域位置及大小和瘤内血流方式：结果（1）未破裂组最大壁面切应力为（7．2±2．9）Pa、射入流宽度比值为0．28（0．20，0．35），与破裂组比较：（7．6±3．3）Pa，0．25（0．20，0．36）]，差异无统计学意义，P〉0．05；②未破裂组射入流最大流速为（0．63±0．18）m／s，低于破裂组的（0．89±0．29）m／s，差异有统计学意义，P〈0．05；术破裂组的冲击域比值为0．5（0．5，0．6），高于未破裂组0．2（0．2，0．3），差异有统计学意义，P〈0．05；S破裂组与未破裂组动脉瘤内的血流方式比较，差异无统计学意义，P〉0．05。结论颅内动脉瘤破裂与动脉熘次载瘤动脉的血流动力学特征有天，颅内破裂动脉瘤较未破裂动脉瘤具有更夫的射入流最大速度和更小的冲击域。

Hemodynamic numerical simulation of unruptured and ruptured intracranial aneurysms

Objective To study the hemodynamic difference between the paired unruptured and ruptured intracranial aneurysms by using numerical simulation in order to obtain the hemodvnamic characteristics of ruptured intracranial aneurysms. Methods The patients with unruptured intracranial aneurysms （unruptured group; n = 12 ） and ruptured intraeranial aneuusms （ruptured group; n = 12） with similar aneurysmal shape and general conditions were selected. 3D rotational angiography image data were used for establishing numerical simulation and hemodvnamic characteristic analvsis for comparison, including the maximum wall shear stress observed in the aneurysms, the maximum velocity and the width of the injection flow, the location and size of the impact domain, and the intra-aneurysmal flow pattern. Results There was no significant difference in the maximum all shear stress （7.2 ±2.9 Pa, 7.6 ±3.3 Pa） and the ratio of flow injection width （0. 28 ± 0. 20, 0.35 ], 0.25 10. 20,0. 36 ] ） between the unruptured group and the ruptured group （ P 〉0.05 ）. The maximum velocity of flow injection 0. 63 ±0. 18 m/s in the unruptured group was lower than 0.89 ±0.29 m/s in the ruptured group. There was significant difference（ P 〈 0.05 ）. The ratio of the impact domain 0. 50 （ 0. 50, 0. 60） in the unruptured group was higher than 0. 2 （0. 2, 0. 3 ） in the ruptured group. There was significant difference（P 〈 0. 05）. @There was no significant difference in the intra-aneurysmal flow pattern between the ruptured and unruptured groups （ P 〉 0. 05）. Conclusion Ptupture of intracranial aneurvsms is associated with the hemodynamic characteristics of aneurysm and its parent arterv. Ruptured intracranial aneusms have greater velocity of injection flow and smaller impact domain than the unruptured intracranial aneurysms.