Correlations between carotid plaque progression and mechanical stresses change sign over time: a patient follow up study using MRI and 3D FSI models

BioMedical Engineering OnLine

Dalin Tang³  Chun Yang²  Gador Canton⁵  Zheyang Wu³  Thomas Hatsukami¹  Chun Yuan⁴ 

[1] Division of Vascular Surgery, University of Washington, Seattle, WA 98195, USA

[2] China United Network Communications Co., Ltd., Beijing, China

[3] Mathematical Sciences Department, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, USA

[4] Deparment of Radiology, University of Washington, Seattle, WA 98195, USA

[5] Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA

关键词: Fluid–structure interaction;    Carotid;    Atherosclerosis;    Flow shear stress;    Plaque progression;   

Others  :  797303
DOI  :  10.1186/1475-925X-12-105

 received in 2013-08-18, accepted in 2013-09-24,  发布年份 2013

【 摘 要 】

Background

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.

Methods

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.

Results

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%).

Conclusion

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.

【 授权许可】

   
2013 Tang et al.; licensee BioMed Central Ltd.

【 图 表 】

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