CRCNS: Modeling for Carotid Plaque Rupture and Stroke

CRCNS：颈动脉斑块破裂和中风建模

• 批准号: 6888372
• 负责人: Dalin Tang
• 金额: $ 27.42万
• 依托单位: WORCESTER POLYTECHNIC INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6888372
• 关键词: atherosclerotic plaque; bioimaging /biomedical imaging; blood vessels; carotid artery; clinical research; computer simulation; endarterectomy; human subject; imaging /visualization /scanning; magnetic resonance imaging; stroke; ultrasound blood flow measurement

DESCRIPTION (provided by applicant): Stroke is the third leading cause of death in the United States which is often caused by atherosclerotic carotid plaque rupture. Stroke may lead to various brain damages, brain malfunctions and disability. A large number of victims who are apparently healthy die suddenly without prior symptoms. Available screening and diagnostic methods are insufficient to identify the victims before the event occurs. The objectives of this project are to integrate computational modeling, Magnetic Resonance Imaging (MRI) technology, ultrasound/Doppler technology (US), mechanical testing, and pathological analysis to perform quantitative mechanical analysis to atherosclerotic carotid plaques, to quantify critical blood flow and plaque stress/strain conditions under which plaque rupture is likely to occur, and to seek the potential that quantitative mechanical analysis can be integrated into state-of-the-art imaging technologies for better screening and diagnostic applications. Those objectives are consistent with the mission of the NIBIB. Forty patients scheduled to undergo carotid endarterectomy will be recruited to participate in this study with proper consent. Fifty additional cadaveric or ex-vivo endarterectomy carotid plaque samples will also be used in the study. The specific aims are: (1) Develop and integrate 3D MRI, US technologies and computational methods to quantify plaque structure and vessel material properties; (2) Develop 3D multi-component computational models with blood- vessel interactions based on in vitro, ex vivo and in vivo measurements obtained by MRI, US technologies and intra- operative measurements; (3) Perform complete mechanical analysis for atherosclerotic plaques and identify correlations between critical stress/strain conditions and plaque morphology and composition, vessel mechanical properties and blood flow pressure conditions; (4) Quantify and validate correlations between critical stress/strain conditions and plaque vulnerability and identify critical stress/strain indicators which could be used by doctors to make clinical and diagnostic decisions. This will establish the base for future software development and technology integration. With large-scale patient study validations, the long term goal is to establish that integration of computational modeling with MRI and US imaging technologies can lead to better interpretation of the information already contained in MRI and ultrasound images, new development of imaging software for more accurate assessment of plaque vulnerability, and potential early prediction of possible stroke. With improved accuracy of predictions, certain unnecessary operations may be avoided, cost of medical care can be reduced, and some fatal events may be prevented. The integrated computational mechanical image analysis improves current image analysis techniques and can serve as basis for many further research activities involving complex biological structures with multi-component interactions.

描述(申请人提供)：中风是美国第三大死亡原因，通常由动脉粥样硬化性颈动脉斑块破裂引起。中风可能会导致各种脑损伤、脑功能障碍和残疾。大量表面上健康的受害者突然死亡，没有先前的症状。现有的筛查和诊断方法不足以在事件发生前确定受害者。该项目的目标是集成计算建模、磁共振成像(MRI)技术、超声/多普勒技术(US)、机械测试和病理分析来对动脉粥样硬化的颈动脉斑块进行定量的机械分析，量化可能发生斑块破裂的临界血流和斑块应力/应变条件，并寻求将定量机械分析集成到最先进的成像技术中以更好地进行筛查和诊断应用的可能性。这些目标与NIBIB的使命一致。40名计划接受颈动脉内膜切除术的患者将在征得适当同意的情况下参与这项研究。这项研究还将使用另外50个身体或体外动脉内膜切除术颈动脉斑块样本。其具体目标是：(1)开发和集成3D MRI、US技术和计算方法，以量化斑块结构和血管材料特性；(2)基于MRI、US技术和术中测量，开发血管-血管相互作用的3D多组分计算模型；(3)对动脉粥样硬化斑块进行完整的力学分析，确定临界应力/应变条件与斑块形态和组成、血管力学特性和血流压力条件之间的关系；(4)量化和验证临界应力/应变状况与斑块易损性之间的相关性，并确定可供医生用于临床和诊断决策的临界应力/应变指标。这将为未来的软件开发和技术集成奠定基础。通过大规模的患者研究验证，长期目标是确定计算建模与MRI和US成像技术的集成可以更好地解释MRI和超声图像中已包含的信息，开发新的成像软件以更准确地评估斑块易损性，并可能早期预测可能的中风。通过提高预测的准确性，可以避免某些不必要的操作，可以降低医疗成本，还可以防止一些致命的事件。集成的计算机械图像分析改进了现有的图像分析技术，可以作为许多涉及复杂生物结构和多组分相互作用的进一步研究活动的基础。