Huang Ruiyun, Chen Hongbing, Li Chenghao, Lie Chaowei, Qiu Zhihua, Jiang Yongjun
Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, 250 Changgang East Road, Guangzhou 510260, China.
Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road II, Guangzhou 510080, China.
Brain Sci. 2022 Oct 17;12(10):1397. doi: 10.3390/brainsci12101397.
Plaque rupture of the basilar artery is one of the leading causes of posterior circulation stroke. The present study aimed to investigate the role of fluid dynamics in the ruptured fibrous cap of basilar artery plaques. Patients with basilar artery plaques (50−99% stenosis) were screened. Integrity of the fibrous cap was assessed by high-resolution MRI. Computational fluid dynamics models were built based on MR angiography to obtain the wall shear stress and velocity. A total of 176 patients were included. High-resolution MRI identified 35 ruptured fibrous caps of basilar artery plaques. Ruptured fibrous cap was significantly associated with acute infarction (27/35 vs. 96/141, p < 0.05) in the territory of the basilar artery. Proximal wall shear stress of stenosis was positively related with the ruptured fibrous cap (OR 1.564; 95% CI, 1.101−2.222; p = 0.013). The threshold of wall shear stress for the ruptured fibrous cap of basilar artery plaques was 4.84 Pa (Area under ROC 0.732, p = 0.008, 95%CI 0.565−0.899). The present study demonstrated that increased proximal wall shear stress of stenosis was associated with ruptured fibrous caps of basilar artery plaques.
基底动脉斑块破裂是后循环卒中的主要原因之一。本研究旨在探讨流体动力学在基底动脉斑块破裂纤维帽中的作用。对患有基底动脉斑块（狭窄率50%-99%）的患者进行筛查。通过高分辨率MRI评估纤维帽的完整性。基于磁共振血管造影构建计算流体动力学模型，以获得壁面剪应力和速度。共纳入176例患者。高分辨率MRI识别出35个基底动脉斑块破裂的纤维帽。基底动脉供血区域内，破裂的纤维帽与急性梗死显著相关（27/35 vs. 96/141，p<0.05）。狭窄处近端壁面剪应力与破裂的纤维帽呈正相关（OR 1.564；95%CI，1.101-2.222；p = 0.013）。基底动脉斑块破裂纤维帽的壁面剪应力阈值为4.84 Pa（ROC曲线下面积0.732，p = 0.008，95%CI 0.565-0.899）。本研究表明，狭窄处近端壁面剪应力增加与基底动脉斑块破裂的纤维帽相关。
