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• Clinical Article •
Computational fluid dynamics and functional outcome in atherosclerotic middle cerebral artery stenosis: A correlation study
WU Jiahua  CHEN Guozhong  WANG Peng  MAO Cunnan  MIAO Zhengfei  SU Wen  YIN Xindao 

Cite this article as: Wu JH, Chen GZ, Wang P, et al. Computational fluid dynamics and functional outcome in atherosclerotic middle cerebral artery stenosis: A correlation study[J]. Chin J Magn Reson Imaging, 2021, 12(6): 10-15. DOI:10.12015/issn.1674-8034.2021.06.003.


[Abstract] Objective To investigate the correlation between hemodynamics and functional outcome in atherosclerotic middle cerebral artery (MCA) stenosis using a computational fluid dynamics (CFD) model based on magnetic resonance angiography (MRA), according to modified Rankin Scale (mRS) at 3 months. Materials andMethods Fifty patients with 50%－99% atherosclerotic MCA stenosis were included. Demographic, imaging data and functional outcome (mRS at 3 months) were collected. Hemodynamic parameters were obtained from CFD models: wall shear stress ratio (WSSR), pressure ratio (PR), velocity ratio (VR), area ratio (AR) and mass flow ratio (MFR). The patients were divided into good functional outcome group and poor functional outcome group based on mRS at 3 months. We compared the clinical variables and hemodynamic parameters between the two groups, and correlation analysis were carried out.Results A total of 50 patients were included. The patients were divided into good functional outcome group (mRS=0－2, n=28) and poor functional outcome group (mRS=3－6, n=22). Compared with good functional outcome group, more patients had a history of hypertension (81.82% vs. 50%, P=0.020), hyperlipidemia (54.55% vs. 25%, P=0.033) and diabetes mellitus (59.09% vs. 28.57%, P=0.030), higher NIHSS at admission (8.82±4.69 vs. 5.96±3.42; P=0.038) and NIHSS at 24 hours (8.00±5.38 vs. 4.39±3.43; P=0.027) in poor functional outcome group. WSSR (3.04±1.56 vs. 8.68±9.67, P=0.002), VR (2.02±0.59 vs. 3.65±2.16, P＜0.001), AR (1.30±0.13 vs. 1.62±0.34, P＜0.001) and MFR (1.42±0.31 vs. 1.94±0.84, P=0.008) in poor functional outcome group were significantly lower than those in good functional outcome group. PR (0.99±0.01 vs. 0.97±0.04, P=0.011) in poor functional outcome group were significantly higher than those in good functional outcome group. Correlation analysis showed that hypertension (r=0.334, P=0.018), diabetes mellitus (r=0.295, P=0.037), NIHSS at admission (r=0.425, P=0.002), NIHSS at 24 hours (r=0.472, P=0.001), WSSR (r=-0.299, P=0.035), VR (r=-0.384, P=0.006) and AR (r=-0.472, P=0.001) had statistically difference with functional outcome.Conclusions Low WSSR, VR, AR, MFR and high PR were more likely to lead to poor functional outcome in atherosclerotic middle cerebral artery stenosis. WSSR, VR and AR had negative correlation with functional outcome in atherosclerotic middle cerebral artery stenosis.
[Keywords] middle cerebral artery；acute ischemic stroke；computational fluid dynamics；magnetic resonance imaging

WU Jiahua   CHEN Guozhong   WANG Peng   MAO Cunnan   MIAO Zhengfei   SU Wen   YIN Xindao*  

Department of Medical Imaging, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China

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

Conflicts of interest   None.

This work was part of Natural Science of Jiangsu Province (No. BK20201118); Science and Technology Development Fund of Nanjing Medical University (No. NMUB2019170).
Received  2020-12-01
Accepted  2021-01-28
DOI: 10.12015/issn.1674-8034.2021.06.003
Cite this article as: Wu JH, Chen GZ, Wang P, et al. Computational fluid dynamics and functional outcome in atherosclerotic middle cerebral artery stenosis: A correlation study[J]. Chin J Magn Reson Imaging, 2021, 12(6): 10-15. DOI:10.12015/issn.1674-8034.2021.06.003.

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