背景:无声磁共振血管造影(MRA)减轻了金属伪影,促进脑动脉瘤支架和弹簧圈栓塞后颈部残留物的清晰可视化。这项研究旨在通过采用无声MRA和计算流体动力学来仔细检查颈部残留物的血液动力学。
方法:作者纵向追踪了部分血栓形成的前交通动脉瘤颈部残留的图像,已经用支架辅助线圈栓塞治疗,使用无声MRA超过十年。计算流体动力学描绘了颈部残留物的还原过程,评估血流动力学参数,如流速,墙体剪应力的大小和矢量,和流线。颈部残留物的表面积逐渐减小,volume,脖子尺寸,圆顶深度,和纵横比。其减少与残余穹顶与流入母体动脉的流速比下降有关。分析描绘了收缩颈部残余内的区域,其特征是始终较低的平均壁剪切应力大小和变化,伴随着墙体剪应力矢量方向性的显着变化。
结论:可以通过无声MRA和计算流体动力学评估支架线圈栓塞后的颈部残留物。可以通过血液动力学参数分析来实现预测颈部残余物减少。
BACKGROUND: Silent magnetic resonance angiography (MRA) mitigates metal artifacts, facilitating clear visualization of neck remnants after stent and coil embolization of cerebral aneurysms. This study aims to scrutinize hemodynamics at the neck remnant by employing silent MRA and computational fluid dynamics.
METHODS: The authors longitudinally tracked images of a partially thrombosed anterior communicating artery aneurysm\'s neck remnant, which had been treated with stent-assisted coil embolization, using silent MRA over a decade. Computational fluid dynamics delineated the neck remnant\'s reduction process, evaluating hemodynamic parameters such as flow rate, wall shear stress magnitude and vector, and streamlines. The neck remnant exhibited diminishing surface area, volume, neck size, dome depth, and aspect ratio. Its reduction correlated with a decline in the flow rate ratio of the remnant dome to the inflow parent artery. Analysis delineated regions within the contracting neck remnant characterized by consistently low average wall shear stress magnitude and variation, accompanied by notable variations in wall shear stress vector directionality.
CONCLUSIONS: Evaluation of neck remnants after stent-coil embolization is possible through silent MRA and computational fluid dynamics. Predicting the neck remnant reduction may be achievable through hemodynamic parameter analysis.