Correlations between carotid plaque progression and mechanical stresses change sign over time: a patient follow up study using MRI and 3D FSI models.
Correlations between carotid plaque progression and mechanical stresses change sign over time: a patient follow up study using MRI and 3D FSI models.
复制标题
颈动脉斑块进展与机械应力之间的相关性随时间变化信号：使用 MRI 和 3D FSI 模型进行的患者随访研究
DOI：
10.1186/1475-925x-12-105
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发表时间：
2013-10-14
影响因子：
3.9
通讯作者：
Yuan C
中科院分区：
文献类型：
--
作者：
Tang D;Yang C;Canton G;Wu Z;Hatsukami T;Yuan C
越来越多的证据表明，控制晚期斑块进展的机制可能不同于早期进展，需要进一步研究。采用连续MRI数据和3D流固相互作用（FSI）模型来确定机械应力与血管壁厚度增加（WTI）测量的晚期斑块进展之间可能的相关性。对患者进行长期随访以收集数据并调查上述相关性是否可重复。在一项随访研究中，我们获得了16例患者的体内MRI数据，每位患者进行2 - 4次扫描（扫描间隔：平均18个月，标准差6.8个月）。以颈动脉分叉为配准点，共形成38对扫描对（基线和随访）进行分析。构建三维FSI模型来获得斑块壁应力（PWS）和流动剪切应力（FSS），以量化它们与斑块进展的相关性。采用线性混合效应模型，考虑节点依赖性，研究WTI与基线PWS和FSS之间可能存在的相关性。38对扫描对中，基线PWS与WTI呈正相关22对，负相关1对，无相关15对。相关征象改变13例（81.25%）。基线FSS与WTI呈负相关16对，正相关1对。相关征象改变12例（75%）。我们的研究结果表明，斑块进展与斑块壁应力总体正相关，与基线血流剪切应力负相关。然而，长期随访显示，在一段时间内确定的斑块进展与机械应力（FSS和PWS）之间的相关性在大多数病例（bbb80 %）中是不可重复的。相关符号变化的原因有待进一步研究。
Increasing evidence suggests that mechanisms governing advanced plaque progression may be different from those for early progression and require further investigation. Serial MRI data and 3D fluid–structure interaction (FSI) models were employed to identify possible correlations between mechanical stresses and advanced plaque progression measured by vessel wall thickness increase (WTI). Long-term patient follow up was used to gather data and investigate if the correlations identified above were reproducible. In vivo MRI data were acquired from 16 patients in a follow-up study with 2 to 4 scans for each patient (scan interval: average 18 months and standard deviation 6.8 months). A total of 38 scan pairs (baseline and follow-up) were formed for analysis using the carotid bifurcation as the registration point. 3D FSI models were constructed to obtain plaque wall stress (PWS) and flow shear stress (FSS) to quantify their correlations with plaque progression. The Linear Mixed-Effects models were used to study possible correlations between WTI and baseline PWS and FSS with nodal dependence taken into consideration. Of the 38 scan pairs, 22 pairs showed positive correlation between baseline PWS and WTI, 1 pair showed negative correlation, and 15 pairs showed no correlation. Thirteen patients changed their correlation sign (81.25%). Between baseline FSS and WTI, 16 pairs showed negative correlation, 1 pair showed positive correlation. Twelve patients changed correlation sign (75%). Our results showed that advanced plaque progression had an overall positive correlation with plaque wall stress and a negative correlation with flow shear stress at baseline. However, long-term follow up showed that correlations between plaque progress and mechanical stresses (FSS and PWS) identified for one time period were not re-producible for most cases (>80%). Further investigations are needed to identify the reasons causing the correlation sign changes.