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不同狭窄程度颈动脉斑块上游、狭窄中心及下游侧的血流动力学参数分布:一项MRI和CFD研究

Hemodynamic parameters distribution of upstream, stenosis center, and downstream sides of plaques in carotid artery with different stenosis: a MRI and CFD study.

作者信息

Sui Binbin, Gao Peiyi, Lin Yan, Jing Lina, Sun Shengjun, Qin Haiqiang

机构信息

Radiology Department, Beijing Neurosurgical Institute, Affiliated Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China.

Radiology Department, Beijing Neurosurgical Institute, Affiliated Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China

出版信息

Acta Radiol. 2015 Mar;56(3):347-54. doi: 10.1177/0284185114526713. Epub 2014 Mar 27.

Abstract

BACKGROUND

Histopathological studies have shown significant differences in plaque components and surface conditions between upstream and downstream of the stenosis. It can be deduced that the flow status near the plaques is different from the flow status at the upstream side, stenosis center, or downstream side of the plaque.

PURPOSE

To study the hemodynamic parameter distribution in different locations near atherosclerotic plaques in the carotid arteries with different stenosis degrees.

MATERIAL AND METHODS

Eleven patients were recruited in this study. CE-MRA was performed to obtain the carotid three-dimensional surface data and the stenosis degrees were calculated. The hemodynamic parameters including wall shear stress (WSS), pressure, and velocity near the plaques were obtained by computational fluid dynamic (CFD) method. Local hemodynamics parameters were analyzed and compared between different stenosis degree groups, and between upstream, stenosis center, and downstream sides of plaques. Relative ratio of velocity, WSS, and pressure values in different locations was calculated and compared.

RESULTS

Fourteen carotid arteries (with 4 mild, 6 moderate, and 4 severe stenosis) were analyzed. Significant differences were found in Pressure max (P = 0.025), Pressure mean (P = 0.020), and Pressure min (P = 0.026) between three stenosis groups. It showed significant differences in Vmin (P < 0.001) and WSSmin (P < 0.001) between three different locations. It showed upstream to downstream ratio of WSSmax (P = 0.034) and WSSmean value (P = 0.042) was significantly different between mild and moderate/severe groups. Significant differences were found in upstream to stenosis center ratio of Pressure max value (P = 0.018), Pressure mean value (P = 0.029), and Pressure min value (P = 0.026), as well as in stenosis center to downstream ratio of Pressure min value (P = 0.042).

CONCLUSION

Velocity, WSS, pressure, and relative ratio of these parameters have certain trends in distribution around the plaques in the carotid arteries.

摘要

背景

组织病理学研究表明,狭窄部位的上游和下游在斑块成分和表面状况方面存在显著差异。可以推断,斑块附近的血流状态与斑块上游侧、狭窄中心或下游侧的血流状态不同。

目的

研究不同狭窄程度的颈动脉粥样硬化斑块附近不同位置的血流动力学参数分布。

材料与方法

本研究招募了11名患者。进行CE-MRA以获取颈动脉三维表面数据并计算狭窄程度。通过计算流体动力学(CFD)方法获得斑块附近的血流动力学参数,包括壁面剪应力(WSS)、压力和速度。分析并比较不同狭窄程度组之间以及斑块的上游、狭窄中心和下游侧之间的局部血流动力学参数。计算并比较不同位置的速度、WSS和压力值的相对比值。

结果

分析了14条颈动脉(4条轻度狭窄、6条中度狭窄和4条重度狭窄)。三个狭窄组之间的最大压力(P = 0.025)、平均压力(P = 0.020)和最小压力(P = 0.026)存在显著差异。三个不同位置之间的最小速度(P < 0.001)和最小WSS(P < 0.001)存在显著差异。轻度与中度/重度组之间的最大WSS(P = 0.034)和平均WSS值(P = 0.042)的上游与下游比值存在显著差异。最大压力值(P = 0.018)、平均压力值(P = 0.029)和最小压力值(P = 0.026)的上游与狭窄中心比值以及最小压力值的狭窄中心与下游比值(P = 0.042)存在显著差异。

结论

颈动脉斑块周围的速度、WSS、压力以及这些参数的相对比值在分布上有一定趋势。

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