基于7.0TMR 4Dflow技术的颅内动脉瘤瘤壁增强的血流动力学机制研究

Intracranial aneurysms are one of the major diseases endangering human health. Once they rupture, the mortality and disability rate is very high, which exerts great pressure on patients, families and society. Previous studies have shown that hemodynamic changes and wall remodeling play an important role in the occurrence, development and rupture of aneurysms. However, the mechanism of wall remodeling and rupture remains unclear. Foreign studies have found that unstable aneurysms often show wall enhancement after intravenous injection of Gd. Previous studies in our group have shown that aneurysmal wall enhancement is associated with aneurysmal instability, but the hemodynamic mechanism of aneurysmal wall enhancement is still unclear. This project will continue to use 7TMR 4D-flow technology to study the hemodynamic mechanism of aneurysmal wall enhancement in magnetic resonance imaging. Pre-experimental results show that the low WSS region is in good agreement with the location of aneurysm wall enhancement.

颅内动脉瘤是危害人类健康的重大疾病之一，一旦破裂出血，致死致残率很高，对患者、 家庭、社会产生重大压力。既往研究表明血流动力学的改变和瘤壁重塑对动脉瘤的发生、发展、破裂起到了重要作用。然而，瘤壁重塑及破裂的机制仍不明确。国外研究发现不稳定动脉瘤在静脉注射扎喷酸葡胺后多表现出瘤壁强化。本课题组的前期研究表明动脉瘤瘤壁强化与动脉瘤不稳定性相关，而动脉瘤壁强化的血流动力学机制仍不清楚。本项目将采用7TMR 4Dflow 技术去研究动脉瘤壁磁共振成像动脉瘤壁强化的血流动力学机制。

颅内动脉瘤是危害人类健康的重大疾病之一，一旦破裂出血，致死致残率很高。既往研究表明血流动力学的改变和瘤壁重塑对动脉瘤的发生、发展、破裂起到了重要作用。然而，瘤壁重塑及破裂的机制仍不明确。国外研究发现不稳定动脉瘤在静脉注射扎喷酸葡胺后多表现出瘤壁强化。本课题组的前期研究表明动脉瘤瘤壁强化与动脉瘤不稳定性相关，而动脉瘤壁强化的血流动力学机制仍不清楚。本项目采用7TMR;4Dflow技术去研究动脉瘤壁磁共振成像动脉瘤壁强化的血流动力学机制。研究结果表明，7T核磁相对3T核磁而言，对于动脉瘤的成像具有较大优势，7T的动脉瘤壁可见度明显优于3T（3.6±1.1 vs 2.7±0.8，p=0.003）；对于>5mm的动脉瘤的分析中，越低的瘤壁切应力（WSS）往往与更高的动脉瘤瘤壁通透性相关，Spearman的相关分析（rho=-0.18，p=0.025）和线性回归分析（r=-0.33，p=0.006），平均壁面剪切应力与瘤壁增强显著相关（p=0.002），标本结果表明，血清IL-1β和IL-1.ra与瘤壁增强相关，在具有瘤壁增强的未破裂动脉瘤中鉴定出更多的焦亡相关蛋白。