2023 Fiscal Year Final Research Report
Prediction of aneurysm rupture point using vessel wall MR imaging and CFD analysis
| Project/Area Number |
21K09117
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 56010:Neurosurgery-related
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| Research Institution | Tohoku University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
中川 敦寛 東北大学, 大学病院, 教授 (10447162)
新妻 邦泰 東北大学, 医工学研究科, 教授 (10643330)
杉山 慎一郎 東北大学, 医学系研究科, 非常勤講師 (30623152)
園部 真也 東北大学, 大学病院, 助教 (30869079)
遠藤 英徳 東北大学, 医学系研究科, 教授 (40723458)
船本 健一 東北大学, 流体科学研究所, 准教授 (70451630)
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Keywords | 瘤壁造影効果 / 脳動脈瘤 / 血管壁イメージング / 破裂点予測 |
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| Outline of Final Research Achievements |
We performed quantitative analyses of Aneurysm wall enhancement (AWE) on consecutive ruptured intracranial aneurysms with multiple blebs (31 aneurysms with a total of 72 blebs), using MR vessel wall imaging. Contrast ratio of aneurysm wall against the stalk (CRstalk) was calculated as the indicator of AWE. Bleb characteristics including CRstalk and wall shear stress (WSS) were compared between ruptured and unruptured blebs. Ruptured blebs had higher CRstalk and lower WSS comparing to unruptured blebs. CRstalk remained significantly associated with ruptured status of blebs in the conditional logistic regression (adjusted odds ratio, 3.9; 95% confidence intervals, 1.6-9.7). AWE is associated with rupture status of blebs independent of WSS. Contrast-enhanced MR vessel wall imaging may serve as a noninvasive tool for identifying the rupture point, which can be useful for making treatment strategy.
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| Free Research Field |
脳神経外科
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| Academic Significance and Societal Importance of the Research Achievements |
今回の検討では破裂点の予測にはMRIにおける瘤壁造影効果が極めて有用であり、従来の方法やCFDを用いた予測に比べても予測精度が高いとの結果が得られた。くも膜下出血症例で破裂部位の情報を術前に低侵襲的に得られる可能性を示しており、これは手術戦略を考える際に大変有用な情報で術中破裂等の合併症回避にもつながる。安全な手術を行う上で極めて有用かつ実践的であり、手術成績の向上にもつながりその臨床的意義・患者さんに与える恩恵は大きい。動脈瘤破裂点を推定するためのソフトウェア開発、さらには未破裂動脈瘤における高危険群抽出にも応用できる可能性もありその波及効果は大きい。
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