Chandran Krishnan B, Wahle Andreas, Vigmostad Sarah C, Olszewski Mark E, Rossen James D, Sonka Milan
Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, 52242-1527, USA.
Crit Rev Biomed Eng. 2006;34(1):23-103. doi: 10.1615/critrevbiomedeng.v34.i1.20.
Atherosclerosis is the underlying cause of most cardiovascular-related deaths in industrialized nations. Determining the etiology of atherosclerosis and detecting lesions in the early stages of the disease for possible pharmacological or mechanical intervention have been challenges facing cardiovascular researchers. In addition to genetic and environmental factors, the formation and growth of atheroma have been linked to the complex fluid dynamics and mass transport in these arterial segments. This article reviews the current state of affairs in imaging modalities and image processing techniques that allow the visualization and morphologically realistic reconstruction of coronary arterial geometry to aid in the diagnosis and treatment of coronary artery disease (CAD). In addition, studies pertaining to our current understanding of the complex flow dynamics in the coronary arteries and the relationship between fluid-induced stresses on the initiation and growth of the atherosclerotic lesions are also reviewed. The article concludes with a brief discussion on possible future directions of research that will advance our knowledge of this challenging problem.
动脉粥样硬化是工业化国家中大多数心血管相关死亡的根本原因。确定动脉粥样硬化的病因并在疾病早期检测病变以便进行可能的药物或机械干预,一直是心血管研究人员面临的挑战。除了遗传和环境因素外,动脉粥样硬化斑块的形成和生长还与这些动脉段中复杂的流体动力学和物质传输有关。本文综述了成像模态和图像处理技术的现状,这些技术能够实现冠状动脉几何形状的可视化和形态逼真的重建,以辅助冠状动脉疾病(CAD)的诊断和治疗。此外,还综述了有关我们目前对冠状动脉中复杂流动动力学的理解以及流体诱导应力与动脉粥样硬化病变的起始和生长之间关系的研究。文章最后简要讨论了可能的未来研究方向,这些方向将推动我们对这一具有挑战性问题的认识。