Correlation between vascular wall shear stress and stenosis degree and plaque characteristics in patients with atherosclerotic stenosis in the middle brain
10.3760/cma.j.cn113694-20211126-00838
- VernacularTitle:大脑中动脉粥样硬化性狭窄患者血管壁剪切应力与狭窄程度和斑块特征的相关性分析
- Author:
Siyu WANG
1
;
Danfeng ZHANG
;
Qiuyue ZHAO
;
Xindao YIN
Author Information
1. 南京医科大学附属南京医院（南京市第一医院）医学影像科，南京210006
- Keywords:
Atherosclerosis;
Intracranial arteriosclerosis;
Middle cerebral artery;
Vascular wall shear stress
- From:
Chinese Journal of Neurology
2022;55(6):612-618
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between wall shear stress (WSS) and the degree of lumen stenosis and plaque characteristics in patients with atherosclerotic stenosis in the middle brain.Methods:Thirty-four patients with moderate to severe unilateral middle cerebral artery stenosis in Nanjing First Hospital from June 2020 to June 2021 were analyzed retrospectively. All patients underwent routine magnetic resonance imaging and vascular wall imaging to obtain plaque parameters such as plaque area, remodeling mode and remodeling index. Based on magnetic resonance angiography, a computational fluid dynamics model was established to simulate the local hemodynamics near the lesion and quantify WSS. The patients were divided into high WSS group and low WSS group according to the median WSS. The differences of clinical baseline data, degree of lumen stenosis and plaque characteristics between the two groups were compared. Pearson correlation analysis was used to calculate the correlation between WSS and lumen stenosis and plaque characteristics.Results:A total of 34 patients were included in this study, 17 in the high WSS group and 17 in the low WSS group. Compared with the low WSS group, the plasma homocysteine level in the high WSS group was lower [(11.10±4.96) μmol/L vs (16.97±6.98) μmol/L, t=-2.83, P=0.010], the degree of stenosis was lower (0.56±0.05 vs 0.66±0.08, t=-4.54, P<0.001), and the proportion of positive lumen remodeling was higher (12/17 vs 4/17, P=0.015). Pearson correlation analysis showed that the degree of lumen stenosis was negatively correlated with WSS ( r=-0.44, P=0.011), and the plaque area was not correlated with WSS. Conclusions:WSS in middle cerebral artery stenosis is related to the degree of lumen stenosis and the mode of vascular remodeling. Higher WSS has poor stability, but lower WSS is more likely to cause lumen stenosis.
