Morphometric and hemodynamic analysis of atherosclerotic progression in human carotid artery bifurcations
Morphometric and hemodynamic analysis of atherosclerotic progression in human carotid artery bifurcations
复制标题
人颈动脉分叉处动脉粥样硬化进展的形态测量和血流动力学分析。
DOI：
10.1152/ajpheart.00464.2015
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发表时间：
2016-03-01
影响因子：
4.8
通讯作者：
Huo, Yunlong
中科院分区：
文献类型：
--
作者：
Huang, Xu;Yin, Xiaoping;Huo, Yunlong
尽管颈动脉分叉处的动脉粥样硬化已被广泛研究，但缺乏疾病不同阶段的形态测量和血流动力学数据。本研究的目的是确定颈动脉疾病患者与健康对照受试者的病变差异。颈动脉分叉的三维 (3D) 几何形状是根据中国对照受试者 (n = 30) 和颈动脉疾病患者 (n = 30) 的计算机断层扫描血管造影 (CTA) 图像重建的。我们定义了两个与 3D 血管重建轮廓相切的新颖矢量角（即角度 1 和 2）。沿着颈内动脉 (ICA) 中心线计算最佳拟合直径。在不同的分叉处进行血流动力学分析。与对照受试者（144±13°和36±16°、5.2±0.57毫米）相比，血管狭窄患者的角度1和2（151±11°和42±20°）较大，颈外动脉（ECA）直径较小（4.6±0.85毫米），但颈总动脉（CCA）没有显着差异（7.1 ± 1.2 与 7.5 ± 1.0 毫米，P = 0.18）。特别是，所有颈动脉疾病患者均出现颈动脉近端狭窄（包括窦区和隆突区），而20%的患者出现中段ICA狭窄，20%患者狭窄扩展至整个颈段ICA。形态测量和血流动力学分析表明，动脉粥样硬化斑块始于 ICA 窦区和隆突区，并向下游发展。
Although atherosclerosis has been widely investigated at carotid artery bifurcation, there is a lack of morphometric and hemodynamic data at different stages of the disease. The purpose of this study was to determine the lesion difference in patients with carotid artery disease compared with healthy control subjects. The three-dimensional (3D) geometry of carotid artery bifurcation was reconstructed from computed tomography angiography (CTA) images of Chinese control subjects (n = 30) and patients with carotid artery disease (n = 30). We defined two novel vector angles (i.e., angles 1 and 2) that were tangential to the reconstructed contour of the 3D vessel. The best-fit diameter was computed along the internal carotid artery (ICA) center line. Hemodynamic analysis was performed at various bifurcations. Patients with stenotic vessels have larger angles 1 and 2 (151 ± 11° and 42 ± 20°) and smaller diameters of the external carotid artery (ECA) (4.6 ± 0.85 mm) compared with control subjects (144 ± 13° and 36 ± 16°, 5.2 ± 0.57 mm) although there is no significant difference in the common carotid artery (CCA) (7.1 ± 1.2 vs. 7.5 ± 1.0 mm, P = 0.18). In particular, all patients with carotid artery disease have a stenosis at the proximal ICA (including both sinus and carina regions), while 20% of patients have stenosis at the middle ICA and 20% have stenosis expansion to the entire cervical ICA. Morphometric and hemodynamic analyses suggest that atherosclerotic plaques initiate at both sinus and carina regions of ICA and progress downstream.