脑静脉窦血流动力学研究方法进展

doi:10.3969/j.issn.1672-6731.2025.06.002

摘要/Abstract

摘要：

脑静脉系统疾病可以导致特发性颅内压增高、脑静脉血栓形成及搏动性耳鸣，精准评估脑静脉窦血流动力学对疾病的诊断与治疗至关重要。随着血流动力学研究软件和神经影像学技术的发展，计算流体力学、四维流动MRI、体外模拟及经颅多普勒超声等为脑静脉窦血流动力学研究提供多维度工具。本文综述上述4种技术在脑静脉窦血流动力学研究中的进展，为脑静脉系统疾病的机制研究提供方法学指导。

关键词: 脑静脉, 血流动力学, 综述

Abstract:

Cerebral venous system diseases can lead to idiopathic intracranial hypertension (IIH), cerebral venous thrombosis (CVT) and pulsatile tinnitus (PT), and accurate evaluation of cerebral venous sinus hemodynamics is very important for the diagnosis and treatment of these diseases. In recent years, with the rapid development of hemodynamics research software and brain imaging technology, computational fluid dynamics (CFD), 4D Flow MRI, vitro simulation and transcranial Doppler ultrasonography (TCD) provide a multi-dimensional tool for the study of hemodynamics. In this paper, we will comprehensively introduce the research progress of above methods in the field of cerebral venous sinus hemodynamics, and provide innovative solutions for subsequent research of cerebral venous system diseases.

Key words: Cerebral veins, Hemodynamics, Review

张嘉豪, 耿磊, 肖志涛, 陈行, 曹向宇. 脑静脉窦血流动力学研究方法进展[J]. 中国现代神经疾病杂志, 2025, 25(6): 464-469.

Jia-hao ZHANG, Lei GENG, Zhi-tao XIAO, Xing CHEN, Xiang-yu CAO. Advances in the study methods of cerebral venous sinus hemodynamics[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2025, 25(6): 464-469.

https://journal11.magtechjournal.com/cjcnn/CN/Y2025/V25/I6/464

图/表 4

图 1 计算流体力学模拟搏动性耳鸣患者脑静脉窦压力分布（红色至蓝色压力递减）

Figure 1 CFD simulation of venous sinus pressure distribution in the patients with PT (pressure decreased from red to blue).

图 2 计算流体力学模拟搏动性耳鸣患者脑静脉窦流速（红色至蓝色流速递减）

Figure 2 CFD simulation of venous sinus velocity in patients with PT (velocity decreased from red to blue).

图 3 脑静脉系统血流动力学体外模拟平台

Figure 3 In vitro simulation platform for hemodynamics of cerebral venous system.

图 4 脑静脉窦血流动力学方法及其相互关系 4D Flow MRI，四维流动MRI；CFD，计算流体力学；TCD，经颅多普勒超声

Figure 4 The content and relationship of hemodynamics methods for cerebral venous sinus.

参考文献 40

1	Chen SW , Chen HX , Xing YQ . Research progress on the relationship between cerebral venous system diseases and cerebral autoregulation. Zhongguo Xian Dai Shen Jing Ji Bing Za Zhi, 2022, 22: 455- 459.
	陈松伟, 陈虹秀, 邢英琦. 脑静脉系统疾病与脑血流自动调节研究进展. 中国现代神经疾病杂志, 2022, 22: 455- 459.
2	Wang Z , Song HQ . Idiopathic intracranial hypertension and intracranial venous sinus stenosis: current status and prospects. Zhonghua Nao Xue Guan Bing Za Zhi (Dian Zi Ban), 2020, 14: 188- 193.
	王族, 宋海庆. 特发性颅内高压症与颅内静脉窦狭窄诊疗现状及展望. 中华脑血管病杂志(电子版), 2020, 14: 188- 193.
3	Xu Z , He H , Xu YG , Bao WY , Zhang S , Zhu M , Wu YY , Yan L , Shui SF . Stent implantation for treating idiopathic intracranial hypertension complicated with venous sinus stenosis. Zhongguo Jie Ru Ying Xiang Yu Zhi Liao Xue, 2024, 21: 513- 516.
	徐振, 何浩, 许莺歌, 包雯颍, 张松, 朱明, 吴垠垠, 闫磊, 水少锋. 植入支架治疗特发性颅内高压症合并静脉窦狭窄. 中国介入影像与治疗学, 2024, 21: 513- 516.
4	Zhang YM , Qi Y , Chen DS , Sun ZT . Research progress on endovascular treatment of intracranial venous sinus thrombosis. Nao Yu Shen Jing Ji Bing Za Zhi, 2024, 32: 780- 785.
	张应猛, 齐艳, 陈东升, 孙支唐. 颅内静脉窦血栓形成的血管内治疗研究进展. 脑与神经疾病杂志, 2024, 32: 780- 785.
5	Zhang HM , Wang AJ , Gao F . Research progress on the treatment of intracranial venous sinus thrombosis. Zhongguo Xiang Cun Yi Yao, 2022, 29: 78- 80.
	张红梅, 王爱菊, 高峰. 颅内静脉窦血栓形成治疗的研究进展. 中国乡村医药, 2022, 29: 78- 80.
6	Xu RM , Wang XC . Imaging analysis of prognostic evaluation of cerebral venous and sinus thrombosis. Ci Gong Zhen Cheng Xiang, 2021, 12: 93- 95.
	许若梅, 王效春. 脑静脉窦血栓形成预后评估的影像学研究进展. 磁共振成像, 2021, 12: 93- 95.
7	Li XX, Cui WN. Etiological classification of pulsatile tinnitus[J/OL]. Ting Li Xue Ji Yan Yu Ji Bing Za Zhi, 2024[2025-03-01]. https://link.cnki.net/urlid/42.1391.R.20240111.1727.028. [Epub ahead of print on January 13, 2024].
	李熙星, 崔卫娜. 搏动性耳鸣的病因分类[J/OL]. 听力学及言语疾病杂志, 2024 [2025-03-01]. https://link.cnki.net/urlid/42.1391.R.20240111.1727.028[网络首发2024-01-13].
8	Lü S , Wang YW . Research progress on vascular pulsatile tinnitus. Zhonghua Er Ke Xue Za Zhi, 2022, 20: 631- 635.
	吕莎, 王耀文. 血管源性搏动性耳鸣的研究进展. 中华耳科学杂志, 2022, 20: 631- 635.
9	Ding HY , Zhao PF , Lü H , Liu XH , Yi XL , Che ZG , Liu ZH , Wang ZC . Research progress on diagnosis, treatment and mechanism of tinnitus based on imaging. Zhongguo Yi Kan, 2022, 57: 583- 588.
	丁贺宇, 赵鹏飞, 吕晗, 刘学焕, 仪晓立, 车子刚, 刘兆会, 王振常. 基于影像学的耳鸣诊疗与机制研究进展. 中国医刊, 2022, 57: 583- 588.
10	Ren L , Liu JH , Ding J , Guo Y , Xia S . Application of blood flow analysis method based on computational fluid dynamics and 4D Flow MRI in diagnosis and treatment of cardiovascular and cerebrovascular diseases. Ci Gong Zhen Cheng Xiang, 2025, 16: 172- 178.
	任蕾, 刘继华, 丁静, 郭瑜, 夏爽. 基于计算流体力学与4D Flow MRI的血流分析方法在心脑血管疾病诊治中的应用进展. 磁共振成像, 2025, 16: 172- 178.
11	Zhang GL , Zhou YR , Wu D , Lu J , Yan S , Zhang S , Tang XY , Qin YY , Zhu WZ . Overview and clinical application of 4D Flow MRI hemodynamic imaging. Fang She Xue Shi Jian, 2022, 37: 4- 9.
	张归玲, 周铱然, 吴迪, 鲁君, 阎肃, 张顺, 汤翔宇, 覃媛媛, 朱文珍. 4D Flow MRI血流动力学成像概述及其临床应用. 放射学实践, 2022, 37: 4- 9.
12	Huang R , Liu WS . Progress in the application of transcranial Doppler ultrasound in cerebral small vessel disease. Shen Jing Ji Bing Yu Jing Shen Wei Sheng, 2019, 19: 731- 734.
	黄蓉, 刘巍松. 经颅多普勒超声应用于脑小血管病的研究进展. 神经疾病与精神卫生, 2019, 19: 731- 734.
13	Qi Y , Lin Z , Lu H , Mao J , Zhang H , Zhao P , Hou Y . Cerebral hemodynamic and metabolic abnormalities in neonatal hypocalcemia: findings from advanced MRI. AJNR Am J Neuroradiol, 2023, 44: 1224- 1230.
14	Li Z , Hou P , Chen Q , Mu S , Li J , Fang Y , Jiang W , Tian X , Wang S . Complex torcular dural arteriovenous fistula leading to cortical venous reflux-induced severe varix and subsequent bilateral cerebral hemispheric hemorrhage: a case report. Front Neurol, 2023, 14: 1303234.
15	Shabbir T , Hunsucker R , Martin D , Shabbir Z , Abou-El-Hassan H , Salahuddin T . A 44-year-old male with cerebral venous sinus thrombosis. Cureus, 2023, 15: e36974.
16	Khalil A , Asseyer S , Rust R , Schmitz-Hübsch T , Fiebach JB , Paul F , Chien C . Non-invasive assessment of cerebral hemodynamics using resting-state functional magnetic resonance imaging in multiple sclerosis and age-related white matter lesions. Hum Brain Mapp, 2024, 45: e70076.
17	Levitt MR , McGah PM , Moon K , Albuquerque FC , McDougall CG , Kalani MYS , Kim LJ , Aliseda A . Computational modeling of venous sinus stenosis in idiopathic intracranial hypertension. AJNR Am J Neuroradiol, 2016, 37: 1876- 1882.
18	Amans MR , Haraldsson H , Kao E , Kefayati S , Meisel K , Khangura R , Leach J , Jani ND , Faraji F , Ballweber M , Smith W , Saloner D . MR venous flow in sigmoid sinus diverticulum. AJNR Am J Neuroradiol, 2018, 39: 2108- 2113.
19	Hong Z , Liu X , Ding H , Zhao P , Gong S , Wang Z , Ghista D , Fan J . Flow patterns in the venous sinus of pulsatile tinnitus patients with transverse sinus stenosis and underlying vortical flow as a causative factor. Comput Methods Programs Biomed, 2022, 227: 107203.
20	Liu X , Du Z , Han T , Ghista DN , Lin S , Wang V , Wang J , Zhang H , Pan G . Quantitative analysis of blood flow in cerebral venous sinus with stenosis by patient-specific CFD modeling. IEEE Access, 2019, 7: 3848- 3854.
21	Hadad S , Rangwala SD , Stout JN , Mut F , Orbach DB , Cebral JR , See AP . Understanding development of jugular bulb stenosis in vein of galen malformations: identifying metrics of complex flow dynamics in the cerebral venous vasculature of infants. Front Physiol, 2023, 14: 1113034.
22	Han Y , Yang Q , Yang Z , Xia J , Su T , Yu J , Jin L , Qiao A . Computational fluid dynamics simulation of hemodynamic alterations in sigmoid sinus diverticulum and ipsilateral upstream sinus stenosis after stent implantation in patients with pulsatile tinnitus. World Neurosurg, 2017, 106: 308- 314.
23	Tian S , Wang L , Yang J , Mao R , Liu Z , Fan Y . Sigmoid sinus cortical plate dehiscence induces pulsatile tinnitus through amplifying sigmoid sinus venous sound. J Biomech, 2017, 52: 68- 73.
24	Stahl J , Abou-Mrad T , Stone McGuire L , Janiga G , Saalfeld S , Alaraj A , Berg P . Flow-based simulation in transverse sinus stenosis pre-and post-stenting: pressure prediction accuracy, hemodynamic complexity, and relationship to pulsatile tinnitus. J Neurointerv Surg, 2025,
25	Schuchardt F , Schroeder L , Anastasopoulos C , Markl M , Bäuerle J , Hennemuth A , Drexl J , Valdueza JM , Mader I , Harloff A . In vivo analysis of physiological 3D blood flow of cerebral veins. Eur Radiol, 2015, 25: 2371- 2380.
26	Li Y , Chen H , He L , Cao X , Wang X , Chen S , Li R , Yuan C . Hemodynamic assessments of venous pulsatile tinnitus using 4D-flow MRI. Neurology, 2018, 91: e586- e593.
27	Ge XQ , Tian CZ , Zhao B . Study on the hemodynamic characterization of venous pulsatile tinnitus using 4D Flow MRI. Ying Xiang Yan Jiu Yu Yi Xue Ying Yong, 2023, 7: 20- 22.
	葛晓乾, 田辰泽, 赵兵. 4D Flow MRI对静脉性搏动性耳鸣的横窦-乙状窦血流特征分析. 影像研究与医学应用, 2023, 7: 20- 22.
28	Lü K , Wang HY , Chai C , Xu KX , Xia S . Exploring the hemodynamic mechanisms of symptomatic changes in venous pulsatile tinnitus during follow-up. Zhongguo Lin Chuang Yi Xue Ying Xiang Za Zhi, 2023, 34: 845- 850.
	吕珂, 王慧颖, 柴超, 徐开旭, 夏爽. 静脉源性搏动性耳鸣随访期间症状改变的血流动力学机制探究. 中国临床医学影像杂志, 2023, 34: 845- 850.
29	Zhang Y , Ma C , Liang S , Li C , Zhu H , Li Z , Miao Z , Tong X , Dong K , Jiang C , Sui B , Mo D . Estimation of venous sinus pressure drop in patients with idiopathic intracranial hypertension using 4D-flow MRI. Eur Radiol, 2023, 33: 2576- 2584.
30	Ding H , Zhao P , Lv H , Li X , Qiu X , Zeng R , Wang G , Yang Z , Gong S , Jin L , Wang Z . Correlation between trans-stenotic blood flow velocity differences and the cerebral venous pressure gradient in transverse sinus stenosis: a prospective 4-dimensional flow magnetic resonance imaging study. Neurosurgery, 2021, 89: 549- 556.
31	Wåhlin A , Eklund A , Malm J . 4D flow MRI hemodynamic biomarkers for cerebrovascular diseases. J Intern Med, 2022, 291: 115- 127.
32	Dai C , Zhao P , Ding H , Lv H , Qiu X , Tang R , Xu N , Huang Y , Han X , Yang Z , Wang Z . Cerebral sinus hemodynamics in adults revealed by 4D Flow MRI. J Magn Reson Imaging, 2024, 60: 1706- 1717.
33	Patel NM , Bartusiak ER , Rothenberger SM , Schwichtenberg AJ , Delp EJ , Rayz VL , Alzheimer's Disease Neuroimaging Initiative . Super-resolving and denoising 4D Flow MRI of neurofluids using physics-guided neural networks. Ann Biomed Eng, 2025, 53: 331- 347.
34	Dempsey S , Safaei S , Holdsworth SJ , Maso Talou GD . Measuring global cerebrovascular pulsatility transmission using 4D flow MRI. Sci Rep, 2024, 14: 12604.
35	Fico BG , Miller KB , Rivera-Rivera LA , Corkery AT , Pearson AG , Loggie NA , Howery AJ , Rowley HA , Johnson KM , Johnson SC , Wieben O , Barnes JN . Cerebral hemodynamics comparison using transcranial doppler ultrasound and 4D flow MRI. Front Physiol, 2023, 14: 1198615.
36	Dai C , Zhao P , Wang G , Ding H , Lv H , Qiu X , Tang R , Xu N , Huang Y , He K , Yang Z , Gong S , Wang Z . Hemodynamic assessments of unilateral pulsatile tinnitus with jugular bulb wall dehiscence using 4D flow magnetic resonance imaging. Quant Imaging Med Surg, 2024, 14: 684- 697.
37	Tian S , Fan X , Wang Y , Liu Z , Wang L . A study on relationship between pulsatile tinnitus and temporal bone pneumatization grade. Comput Methods Biomech Biomed Engin, 2019, 22: 788- 796.
38	Valluru K , Parkhill J , Gautam A , Haraldsson H , Kao E , Leach J , Wright A , Ballweber M , Meisel K , Saloner D , Amans M . Sound measurement in patient-specific 3D printed bench models of venous pulsatile tinnitus. Otol Neurotol, 2020, 41: e7- e14.
39	Wu J , Zhao QL , Bu W , Wang F . The study of the relationship between haemodynamic of basal vein and intracranial pressure after head trauma. Hebei Yi Ke Da Xue Xue Bao, 2008, 29: 523- 524.
	吴健, 赵庆林, 步玮, 王峰. 脑损伤后基底静脉血流动力学与颅内压关系的研究. 河北医科大学学报, 2008, 29: 523- 524.
40	Zhang JF , Liu GR , Li YC , Wang BJ , Jiang CC . Venous series monitoring by transcranial Doppler ultrasound in cerebral sinus thrombosis. Nao Yu Shen Jing Ji Bing Za Zhi, 2012, 20: 443- 447.
	张京芬, 刘国荣, 李月春, 王宝军, 姜长春. TCD动态监测静脉窦血栓形成五例. 脑与神经疾病杂志, 2012, 20: 443- 447.

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