Evaluating the Impact of Calcification on Plaque Vulnerability from the Aspect of Mechanical Interaction Between Blood Flow and Artery Based on MRI
Evaluating the Impact of Calcification on Plaque Vulnerability from the Aspect of Mechanical Interaction Between Blood Flow and Artery Based on MRI
复制标题
基于MRI从血流与动脉之间的机械相互作用方面评估钙化对斑块脆弱性的影响。
DOI：
10.1007/s10439-020-02655-1
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发表时间：
2020-10-20
影响因子：
3.8
通讯作者：
Li, Zhiyong
中科院分区：
文献类型：
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作者：
Benitez, Jessica;Fontanarosa, Davide;Li, Zhiyong
急性脑缺血事件和血栓形成与颈动脉粥样硬化斑块的破裂/侵蚀有关。本研究的目的是使用三维流体-结构相互作用（FSI）模型确定钙化沉积对壁面剪切应力（WSS）和斑块内应力的影响。对6例颈动脉粥样硬化钙化患者进行多序列磁共振成像（MRI）检查，根据钙化体积分为3组。为了评价钙化沉积对应力的作用，分别用脂质和动脉组织代替钙化含量。通过比较模拟结果与钙化，以及当将其改变为脂质时，纤维帽处的应力显著增加（p = 0.004）。相反，通过将其改为动脉组织，没有显著差异（p = 0.07）。呈现最高应力的钙化形状为薄凹弧形（AS 1）和薄凸弧形（AS 3），平均应力值分别为107 +/- 54.2和99.6 +/- 23.4 kPa。还观察到，钙化形状对应力水平的影响大于其与管腔的距离。较高的WSS值与钙化的存在相关。钙化形状在斑块中产生高应力方面起着重要作用。这项工作进一步阐明了钙化对斑块易损性的影响。
Acute cerebral ischemic events and thrombosis are associated with the rupture/erosion of carotid atherosclerotic plaques. The aim of the present study was to determine the impact of calcification deposition on the wall shear stress (WSS) and stresses within the plaques using 3D fluid-structure interaction (FSI) models. Six patients with calcified carotid atherosclerosis underwent multisequence magnetic resonance imaging (MRI) and were divided into three groups according to the calcification volume. To evaluate the role of the calcification deposition on the stresses, the calcification content was replaced by lipids and arterial tissue, respectively. By comparing the results from the simulation with calcification, and when changing it to lipids there was a significant increment in the stresses at the fibrous cap (p = 0.004). Instead, by changing it to arterial tissue, there was no significant difference (p = 0.07). The calcification shapes that presented the highest stresses were thin concave arc-shaped (AS1) and thin convex arc-shaped (AS3), with mean stress values of 107 +/- 54.2 and 99.6 +/- 23.4 kPa, respectively. It was also observed that, the calcification shape has more influence on the level of stress than its distance to the lumen. Higher WSS values were associated with the presence of calcification. Calcification shape plays an important role in producing high stresses in the plaque. This work further clarifies the impact of calcification on plaque vulnerability.