Carotid atheroma rupture observed in vivo and FSI-predicted stress distribution based on pre-rupture imaging.
Carotid atheroma rupture observed in vivo and FSI-predicted stress distribution based on pre-rupture imaging.
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DOI：
10.1007/s10439-010-0004-8
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发表时间：
2010-08
影响因子：
3.8
通讯作者：
Saloner, David
中科院分区：
文献类型：
--
作者：
Leach, Joseph R.;Rayz, Vitaliy L.;Soares, Bruno;Wintermark, Max;Mofrad, Mohammad R. K.;Saloner, David
颈动脉分叉处的动脉粥样硬化是中风的主要危险因素。由于机械力可能影响病变稳定性，因此已对病变血管模型进行了有限元研究，以阐明病变特征对斑块材料内应力的影响。希望患者特异性生物力学分析可以在临床上评估任何特定病变的破裂可能性，从而更好地将患者分层为最合适的治疗。由于体内斑块破裂数据的稀疏性，各种机械描述符（如应力或应变）与破裂易损性之间的关系尚不完全清楚，并且生物力学分析的患者特异性效用尚不清楚。在这篇文章中，我们提出了一个比较在体内观察到的颈动脉粥样硬化破裂和斑块应力分布的流体-结构相互作用分析的基础上破裂前的医学成像。图像分辨率的影响进行了探讨和计算的应力场显示变化多达50%的亚像素几何不确定性。在这些范围内，我们发现一个区域内的纤维斑块层的病变与相应的位置和程度的斑块破裂的观察网站的应力明显升高。
Atherosclerosis at the carotid bifurcation is a major risk factor for stroke. As mechanical forces may impact lesion stability, finite element studies have been conducted on models of diseased vessels to elucidate the effects of lesion characteristics on the stresses within plaque materials. It is hoped that patient-specific biomechanical analyses may serve clinically to assess the rupture potential for any particular lesion, allowing better stratification of patients into the most appropriate treatments. Due to a sparsity of in vivo plaque rupture data, the relationship between various mechanical descriptors such as stresses or strains and rupture vulnerability is incompletely known, and the patient-specific utility of biomechanical analyses is unclear. In this article, we present a comparison between carotid atheroma rupture observed in vivo and the plaque stress distribution from fluid–structure interaction analysis based on pre-rupture medical imaging. The effects of image resolution are explored and the calculated stress fields are shown to vary by as much as 50% with sub-pixel geometric uncertainty. Within these bounds, we find a region of pronounced elevation in stress within the fibrous plaque layer of the lesion with a location and extent corresponding to that of the observed site of plaque rupture.
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