Characterization of the atherosclerotic carotid bifurcation using MRI, finite element modeling, and histology
Characterization of the atherosclerotic carotid bifurcation using MRI, finite element modeling, and histology
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DOI：
10.1023/b:abme.0000032456.16097.e0
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发表时间：
2004-07-01
影响因子：
3.8
通讯作者：
Kamm, RD
中科院分区：
文献类型：
--
作者：
Kaazempur-Mofrad, MR;Isasi, AG;Kamm, RD
已知动脉粥样硬化发生与作用于动脉壁上或动脉壁内的应力有关。然而，动脉粥样硬化病变的不均匀分布和血管重塑对疾病进展的影响仍知之甚少。提出了一种研究动脉粥样硬化的流体动力学参数和组织学标志物之间的相关性的方法。研究了4例晚期颈动脉分叉病变患者的初步数据，并与文献中的假设进行了比较。四名患者使用MRI和超声扫描，随后接受颈动脉内膜切除术。对于每个患者，从MR数据构建几何模型和数值网格，并建立速度边界条件。计算得出平均壁面剪应力（WSS）、最大壁面剪应力时间梯度（WSSTG）和振荡剪切指数（OSI）的值。手术后，将切除的斑块切片，对平滑肌细胞（SMC）、巨噬细胞（MO）、脂质（LIP）和胶原蛋白（COL）进行染色，并进行定量分析。各种流体动力学变量和生物标志物之间的相关性是有趣的，但不确定。WSSTG和WSS与Mphi和LIP呈负相关，与COL和SMC呈正相关，以及OSI与Mphi和LIP呈正相关，与COL和SMC呈负相关。这些趋势与文献中基于离体和体外实验研究的假设一致。
Atherogenesis is known to be associated with the stresses that act on or within the arterial wall. Still, the uneven distribution of atherosclerotic lesions and the impact of vessel remodeling on disease progression are poorly understood. A methodology is proposed to study the correlations between fluid dynamic parameters and histological markers of atherosclerosis. Trends suggested by preliminary data from four patients with advanced carotid bifurcation arterial disease are examined and compared to hypotheses in the literature. Four patients were scanned using MRI and ultrasound, and subsequently underwent carotid endarterectomy. For each patient, a geometric model and a numerical mesh were constructed from MR data, and velocity boundary conditions established. Computations yield values for average wall shear stress (WSS), maximum wall shear stress temporal gradient (WSSTG), and Oscillatory Shear Index (OSI). Following surgery, the excised plaques were sectioned, stained for smooth muscle cells (SMC), macrophages (MO), lipid (LIP), and collagen (COL), and analyzed quantitatively. Correlations attempted between the various fluid dynamic variables and the biological markers were interesting but inconclusive. Tendencies of WSSTG and WSS to correlate negatively with Mphi and LIP, and positively with COL and SMC, as well as tendencies of OSI to correlate positively with Mphi and LIP and negatively with COL and SMC, were observed. These trends agree with hypotheses in the literature, which are based on ex vivo and in vitro experimental studies.