破裂与未破裂镜像后交通动脉瘤形态与血流动力学分析

目的探讨破裂与未破裂颅内动脉瘤的血流动力学与形态学差异，分析动脉瘤破裂的危险因素。方法回顾性分析8例镜像后交通动脉瘤病人（均为一侧破裂，一侧未破裂）的临床资料，均行3D—DSA检查，建立数值模型。将16个动脉瘤按是否破裂分组，分析破裂组与未破裂组之间的形态学与血流动力学参数特征。结果破裂组动脉瘤平均擘面切应力（WSS）明显低于未破裂组（P〈0．05）；而低壁面切应力面积（LSA）比率和体颈比值明显高于未破裂组（P〈0．05）。剪切震荡指数（OSI）、动脉瘤直径、大小比率、血管角度和动脉瘤倾角组间差异无统计学意义（P〉0．05）。结论镜像后交通动脉瘤可能是研究动脉瘤破裂风险的理想模型，血流动力学与形态学在判断动脉瘤破裂风险方面同等重要。

Morphological and hemodynamic analysis for ruptured and unruptured mirror posterior communicating artery aneurysms

Objective To explore the hemodynamic and morphological differences between ruptured and unruptured intracranial aneurysms, and analyze the risk factor for ruptured aneurysms. Methods Clinical data of 8 patients with mirror posterior communicating artery aneurysms with one side ruptured and the other side unruptured were analyzed retrospectively. 3D-DSA was performed in 8 patients and numerical model was established. Sixteen aneurysms were divided into ruptured group and unruptured group, and morphological and hemodynamic parameters were analyzed. Results The mean wall shear stress （WSS） of the aneurysm in ruptured group was significantly lower than that in unruptured group （P 〈 0.05）. The low wall shear stress area ratio and aneurysm ratio （AR） in ruptured group were higher than those in unruptured group （P 〈 0.05）. However, there were no significant differences between the two groups in the parameters such as oscillatory shear index （OSI）, aneurysm size, size ratio, vessel angle and aneurysm inclination angle （P 〈 0.05）. Conclusions The mirror posterior communicating artery aneurysms may be an ideal model to investigate the risk factors for aneurysm rupture. Hemodynamics is as important as morphology in judging the risk of aneurysm rupture.