应用计算机流体力学方法评估多发性颅内动脉狭窄患者各狭窄病灶发生卒中风险的差异

项目名称： 应用计算机流体力学方法评估多发性颅内动脉狭窄患者各狭窄病灶发生卒中风险的差异

项目编号： No.81501004

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 濮月华

作者单位： 首都医科大学

项目金额： 17.5万元

中文摘要： 颅内动脉粥样硬化性狭窄或闭塞是缺血性卒中的重要病因亚型。一直以来，动脉粥样硬化病灶的狭窄程度被认为是临床治疗和研究的主要参考指标。然而，在临床工作中人们发现，狭窄率并不能完全反应缺血的风险，而狭窄处血流动力学的状态、狭窄区域侧支循环的程度及狭窄远端的灌注损伤是更重要的参考指标。血流动力学研究在脑血管病领域具有广泛的应用前景。现有研究提出了基于无创技术的计算机血流动力学评估方法，但这些计算方法并没有得到充分的验证。本研究拟通过微导管测压技术对计算机流体力学模拟计算血流分数的方法进行验证，比较基于不同影像学检查方法所得出结果的一致性。并将验证过的方法应用于现有卒中数据库中，通过计算多发颅内动脉狭窄患者各狭窄病灶的血流分数，预测卒中复发的风险，为将来进一步开展临床试验、探索新的治疗方法奠定基础，为准确筛选高危血管提供可靠的工具。

中文关键词： 颅内动脉狭窄；血流动力学；缺血性脑卒中；预后

英文摘要： Intracranial atherosclerotic stenosis or occlusion is an important etiology subtype of ischemic stroke. All the time since, stenosis severity was thought to be the main reference index for clinical treatment and research. However, in routine work clinicians found the percentage of stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation and perfusion impairment downstream the stenosis are more important. Hemodynamic study has wide application prospect in the field of cerebrovascular disease. Some current studies have developed an assessment method by computational fluid dynamics (CFD) based on noninvasive image acquisition technique, but these have not been fully validated. This study was aimed to validate the method of CFD simulating fractional flow calculation by pressure guide wire measurement technology and compared the consistency of results based on different imaging methods. We also aimed to take the validated method existing to stroke database, calculate the fractional flow of each lesion for patients with multiple intracranial artery stenoses, predict the risk of recurrent stroke, lay the foundation for further clinical trials and new treatment, provide the reliable tool for selecting high-risk vascular lesions.

英文关键词： intracranial stenosis ;hemodynamics;ischemic stroke;outcome