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• Clinical Article •
Computational fluid dynamics analysis of hemorrhagic transformation after reperfusion therapy in acute ischemic stroke patients with middle cerebral artery occlusion
TANG Jie  CHEN Guozhong  MAO Cunnan  SU Wen  YIN Xindao 

Cite this article as: Tang J, Chen GZ, Mao CN, et al. Computational fluid dynamics analysis of hemorrhagic transformation after reperfusion therapy in acute ischemic stroke patients with middle cerebral artery occlusion . Chin J Magn Reson Imaging, 2020, 11(3): 161-165. DOI:10.12015/issn.1674-8034.2020.03.001.


[Abstract] Objective: To explore the relationship between hemodynamics of acute ischemic stroke (AIS) caused by middle cerebral artery occlusion and hemorrhagic transformation (HT) after reperfusion therapy based on computational fluid dynamics (CFD).Materials and Methods: A total of 38 AIS patients with middle cerebral artery occlusion confirmed by magnetic resonance angiography (MRA) were included. The data of MRA before treatment and general clinical data at admission were collected and analyzed retrospectively. Based on MRA-CFD models, hemodynamic parameters were obtained as follows: pressure, wall shear stress (WSS) and wall shear stress gradient (WSSG). Rpressure, RWSS, RWSSG is defined as the ratio of pressure, WSS, WSSG at the beginning of middle cerebral artery to the normal diameter of occlusion, respectively. All patients received standard treatment. According to whether there is bleeding on CT or MRI within 48 hours after treatment, the patients were divided into bleeding group and non-bleeding group. We compared the differences of clinical and hemodynamic parameters between the two groups and underwent correlation analysis.Results: Out of 38 patients, there were 17 patients in the bleeding group and 21 patients in the non-bleeding group. Compared with the non-bleeding group, the bleeding group had more hypertension patients (P=0.008), higher admission systolic blood pressure [(149.1±23.9) mm Hg VS (139.3±16.3) mm Hg, P=0.024] and diastolic blood pressure [(90.2±16.7) mm Hg VS (87.7±8.5) mm Hg, P=0.008], higher plasma homocysteine [(16.6±11.1) µmol/L VS (13.2±3.5) µmol/L, P=0.024]. RWSS and RWSSG in the bleeding group were higher than those in the non-bleeding group (P<0.05), while there was no statistical difference regarding to Rpressure (P>0.05). Correlation analysis showed that hypertension (r=-0.428, P=0.007) and RWSS (r=-0.341, P=0.036) had statistical difference with HT after reperfusion therapy.Conclusions: Hypertension, local intravascular RWSS were associated with HT after reperfusion therapy in patients with acute ischemic stroke due to middle cerebral artery occlusion, hypertension and local intravascular high RWSS before treatment were more likely to lead to HT after reperfusion treatment.
[Keywords] computational fluid dynamics；acute ischemic stroke；magnetic resonance imaging

TANG Jie Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

CHEN Guozhong Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

MAO Cunnan Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

SU Wen Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

YIN Xindao* Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

*Correspondence to: Yin XD, E-mail: y.163yy@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  Jiangsu Provincial Special Program of Medical Science No. BE2017614
Received  2019-09-30
Accepted  2020-02-12
DOI: 10.12015/issn.1674-8034.2020.03.001
Cite this article as: Tang J, Chen GZ, Mao CN, et al. Computational fluid dynamics analysis of hemorrhagic transformation after reperfusion therapy in acute ischemic stroke patients with middle cerebral artery occlusion . Chin J Magn Reson Imaging, 2020, 11(3): 161-165. DOI:10.12015/issn.1674-8034.2020.03.001.

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