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ニューロサイエンスの旅 Vol. 67

当科の堀 恵美子先生が、コンピューターによる血流解析(CFD)を用いて、中大脳動脈瘤の壁が菲薄化する因子について解析した結果が「脳神経外科」に掲載されました。
堀 恵美子、堀 聡、尾矢公子、高 正圭、柏崎大奈、岡本宗司、柴田 孝、久保道也、堀江幸男、黒田 敏
CFDによる動脈瘤の壁の厚さに関する検討—translucent typeの未破裂中大脳動脈瘤は術前に予測できるか?—
脳外48:15-23, 2020

A Voyage to Depth of Neuroscience Vol. 67

One of our staff, Dr. Emiko Hori has published her recent data on computed flow dynamics (CFD) to determine the wall thinning of the middle cerebral artery aneurysm.
Hori E, Hori S, Oya K, Ko M, Kashiwazaki D, Okamoto S, Shibata T, Kubo M, Horie Y, Kuroda S:
The Analysis of the Thickness of a Cerebral Aneurysm:Can Predict the Translucent-type of Unruptured Middle Cerebral Artery Aneurysm Preoperatively?
No Shinkei Geka. 2020 Jan;48(1):15-23.
https://www.ncbi.nlm.nih.gov/pubmed/31983684

Abstract
OBJECT:
The rupture risk of cerebral aneurysms is determined by various factors. However, it is not clear whether the thickness of the aneurysm wall also influences the rupture risk. In this study, under the assumption that thin-walled aneurysms have a higher rupture risk compared with thick-wall aneurysms, we evaluate the usefulness of computed fluid dynamics(CFD)to identify thin-walled cerebral aneurysms.
METHODS:
Fifty-four unruptured middle cerebral aneurysms from 53 patients were analyzed using CFD before the operation. We divided these aneurysms into two groups: translucent-type aneurysms and others. To analyze the difference of these groups, individual elements(age, gender, volume, and aspect ratio)and hemodynamic factors(wall shear stress[WSS], flow coefficient, and flow coefficient per volume)were examined using CFD.
RESULTS:
Univariate analysis detected significant relationships between the translucent-type aneurysms and gender, aspect ratio, WSS and flow coefficient per volume. Multiple logistics regression also identified a significant relationship with gender and flow coefficient per volume. The receiver operating characteristic curve demonstrated that the flow coefficient per volume could predict translucent-type aneurysms(area under the curve 0.84, cut-off value 1.32, sensitivity 76.2%, and specificity 87.9%).
CONCLUSION:
Gender and the flow coefficient per volume could predict translucent-type aneurysms of the middle cerebral artery. CFD analysis might be a useful tool to predict translucent-type aneurysms.

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