Correlation analysis of vertebral artery hemodynamic differences and clinical symptoms due to craniocervical junction abnormalities: based on computational fluid dynamics

Abstract

Abstract Background and purpose Patients with craniocervical junction abnormalities (CJA) often exhibit vertebral artery (VA) abnormalities, and identifying these abnormalities can be beneficial for assessing patient symptoms and developing treatment plans. Material and Methods Sixty patients with CJA were admitted to our department from January 2018 to June 2022. Sixty healthy people were selected to undergo combined head and neck CTA, and the CTA images were imported into CFD-related software. The results were used to visualize and derive the lumen diameter (D), peak systolic velocity (PSV), mean blood flow velocity (MV), wall pressure (WP), wall shear stress (WSS) and other related data of vertebral arteries in different segments, and cross-sectional planes of the vertebral arteries at different segments were constructed to calculate the quantity of blood flow (Q) and the ratio of each index in each segment. The dizziness handicap inventory (DHI) was chosen to assess patient dizziness symptoms, and a multinomial logistic model was used to analyze the correlation between differences in vertebral artery hemodynamics due to patients with CJA and clinical symptoms such as dizziness. Results Compared with those in the control group, the mean DV3−V4, D\(\frac{\text{V}3-\text{V}4}{\text{V}1-\text{V}2}\)、QV3−V4、Q\(\frac{\text{V}3-\text{V}4}{\text{V}1-\text{V}2}\) of VA in the CJA group were significantly lower; the PSVV3−V4, PSV\(\frac{\text{V}3-\text{V}4}{\text{V}1-\text{V}2}\)、MVV1−V2、MVV3−V4、MV\(\frac{\text{V}3-\text{V}4}{\text{V}1-\text{V}2}\), WP and WSS in the CJA group were significantly greater; and the difference was statistically significant (P<0.05). According to the multinomial logistic regression analysis, for every 0.02 unit decrease in QV3−V4, the risk of increasing the DHI score to a higher grade increased by 40.49% compared with the original basis. Conclusions The V3-V4 segment of the vertebral artery in patients with CJA differs from that in the normal population in terms of hemodynamics, such as D, V, WP, and WSS, especially Q, and these differences lead to the occurrence of clinical symptoms such as dizziness and vertigo. The quantity of blood flow is negatively correlated with DHI, and age is positively correlated with DHI.