椎基底动脉迂曲扩张症的计算流体力学分析 [中文引用][英文引用]

 [摘要] 目的 基于磁共振血管造影(MRA)的椎基底动脉迂曲扩张症（VBD）计算机流体力学分析。 方法  选取2018年1月至2022年1月牡丹江医学院附属红旗医院诊断为VBD的40例患者，经MRI检查正常的40例患者图像。以椎基底动脉MRA图像构建椎基底动脉三维几何模型，分为VBD组与对照组，分析血流速度（V）、壁面剪切应力（WSS）及震荡剪切系数（OSI）。 结果 VBD组V、WSS及OSI均高于对照组，差异均有统计学意义（P<0.05）。在血流速度方面，高速血流集中于基底动脉及右侧大脑后动脉处。在WSS方面，VBD组高WSS位于右侧椎动脉、基底动脉、双侧大脑后动脉等大部分血管区域，以血管分叉处显著。在OSI方面，VBD组高OSI值以基底动脉末端至双侧大脑后动脉发出处明显，其余血管区域为波动性高OSI分布。 结论  基于真实磁共振患者图像可建立三维个体化血管模型及进行血流动力学分析，获取VBD血流速度图、血管剪切应力云图及震荡剪切系数云图。建立VBD组及对照组模型，分析血流动力学发现，VBD组的基底动脉段具有高速血流、高WSS及高OSI，以末端显著，临床上应着重关注此区域。

 [Abstract]  Objective  Computational fluid dynamics analysis of vertebrobasilar artery tortuous dilatation (VBD) based on magnetic resonance angiography (MRA). Methods  Forty patients diagnosed with VBD from January 2018 to January 2022 in Hongqi Hospital Affiliated to Mudanjiang Medical University were selected and the images of 40 patients with normal MRI examination were selected. The vertebrobasilar artery MRA images were used to construct a three-dimensional geometric model of the vertebrobasilar artery, which was divided into VBD group and control group, and blood flow velocity (V), wall shear stress (WSS) and oscillatory shear index (OSI) were analyzed. Results  V, WSS and OSI in the VBD group than those in the control group, and all differences were statistically significant (P<0.05). In terms of blood flow velocity, the high velocity blood flow was concentrated at the basilar artery and the right posterior cerebral artery. In terms of WSS, the high WSS in the VBD group was located in most of the vascular areas of the right vertebral artery, basilar artery and bilateral posterior cerebral arteries, and was significant at the vascular bifurcation. In terms of OSI, the high OSI values in the VBD group were obvious from the end of the basilar artery to the bilateral posterior cerebral arteries, and the rest of the vascular regions had fluctuating high OSI distribution. Conclusion  Three-dimensional individualized vascular models and hemodynamic analysis can be established based on real MRI patient images, and VBD blood flow velocity maps, vascular shear stress clouds and oscillatory shear index clouds can be obtained. In the VBD group and the control group, hemodynamic analyses reveal that the basilar artery segment in the VBD group has high velocity flow, high WSS and high OSI, which is significant at the end, and clinical attention should be focused on this region.