Groen Harald C, Gijsen Frank J H, van der Lugt Aad, Ferguson Marina S, Hatsukami Thomas S, van der Steen Anton F W, Yuan Chun, Wentzel Jolanda J
Biomedical Engineering, Biomechanics Laboratory, Erasmus MC, CA Rotterdam, The Netherlands.
Stroke. 2007 Aug;38(8):2379-81. doi: 10.1161/STROKEAHA.107.484766. Epub 2007 Jul 5.
Cerebrovascular events are related to atherosclerotic disease in the carotid arteries and are frequently caused by rupture of a vulnerable plaque. These ruptures are often observed at the upstream region of the plaque, where the wall shear stress (WSS) is considered to be highest. High WSS is known for its influence on many processes affecting tissue regression. Until now, there have been no serial studies showing the relationship between plaque rupture and WSS. Summary of Case- We investigated a serial MRI data set of a 67-year-old woman with a plaque in the carotid artery at baseline and an ulcer at 10-month follow up. The lumen, plaque components (lipid/necrotic core, intraplaque hemorrhage), and ulcer were segmented and the lumen contours at baseline were used for WSS calculation. Correlation of the change in plaque composition with the WSS at baseline showed that the ulcer was generated exclusively at the high WSS location.
In this serial MRI study, we found plaque ulceration at the high WSS location of a protruding plaque in the carotid artery. Our data suggest that high WSS influences plaque vulnerability and therefore may become a potential parameter for predicting future events.
脑血管事件与颈动脉粥样硬化疾病相关，且常由易损斑块破裂引起。这些破裂常发生在斑块的上游区域，该区域的壁面切应力（WSS）被认为是最高的。高WSS因其对影响组织消退的许多过程的影响而为人所知。到目前为止，尚无系列研究表明斑块破裂与WSS之间的关系。病例总结——我们研究了一名67岁女性的系列MRI数据集，该女性基线时颈动脉有斑块，10个月随访时有溃疡形成。对管腔、斑块成分（脂质/坏死核心、斑块内出血）和溃疡进行了分割，并使用基线时的管腔轮廓进行WSS计算。斑块成分变化与基线时WSS的相关性表明，溃疡仅在高WSS位置产生。
在这项系列MRI研究中，我们在颈动脉突出斑块的高WSS位置发现了斑块溃疡。我们的数据表明，高WSS会影响斑块易损性，因此可能成为预测未来事件的一个潜在参数。
