論文

国際誌
2023年9月1日

Hemodynamic and morphological differences in cerebral aneurysms between before and after rupture.

Journal of neurosurgery
  • Soichiro Fujimura
  • ,
  • Yuma Yamanaka
  • ,
  • Hiroyuki Takao
  • ,
  • Toshihiro Ishibashi
  • ,
  • Katharina Otani
  • ,
  • Kostadin Karagiozov
  • ,
  • Koji Fukudome
  • ,
  • Makoto Yamamoto
  • ,
  • Yuichi Murayama

開始ページ
1
終了ページ
9
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3171/2023.6.JNS23289

OBJECTIVE: Although it has been proposed that aneurysm morphology is different after rupture, detailed research of the morphological changes using 3D imaging acquired before and after rupture has not been conducted because of the difficulty of data collection. Similarly, hemodynamic changes due to morphological alterations after rupture have not been analyzed. The aim of this study was to investigate the changes in morphology and hemodynamics observed after aneurysm rupture. METHODS: For 21 cerebral aneurysms (21 patients) that ruptured during observation, 3D geometry of the aneurysms and parent arteries were reconstructed based on the angiographic images before and after their rupture. In addition, using the reconstructed geometry, blood flow was simulated by computational fluid dynamics (CFD) analysis. Morphological and hemodynamic parameters were calculated both before and after rupture, and their changes from before to after were compared. RESULTS: In the morphological parameters, statistically significantly higher values were observed after rupture in height (before: 5.5 ± 2.1 mm, after: 6.1 ± 2.0 mm; p < 0.0001), aspect ratio (p = 0.002), aneurysm volume (p = 0.04), and undulation index (p = 0.005). In terms of hemodynamic changes, the mean normalized wall shear stress (NWSS) decreased significantly (before: 5.4 × 10-1 ± 2.9 × 10-1, after: 4.4 × 10-1 ± 2.8 × 10-1; p < 0.001) as well as the other NWSS parameters, including maximum and minimum NWSS, which were associated with stagnant flow due to the morphological changes after rupture. CONCLUSIONS: Aneurysm morphology was found to change after rupture into an elongated and irregular geometry, accompanied by an increase in aneurysm volume. These morphological changes were also associated with statistically significant hemodynamic alterations that produced low wall sheer stress by stagnant flow. The authors' results also provide the opportunity to explore and develop a risk evaluation method for aneurysm rupture based on prerupture morphology and hemodynamics by further exploration in this direction.

リンク情報
DOI
https://doi.org/10.3171/2023.6.JNS23289
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/37657114
ID情報
  • DOI : 10.3171/2023.6.JNS23289
  • PubMed ID : 37657114

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