Utility of Magnetic Resonance Imaging-Based Finite Element Analysis for the Biomechanical Stress Analysis of Hemorrhagic and Non-Hemorrhagic Carotid Plaques

Abstract

Background: Biomechanical stress analysis has been used for plaque vulnerability assessment. The presence of plaque hemorrhage (PH) is a feature of plaque vulnerability and is associated with thromboembolic ischemic events. The purpose of the present study was to use finite element analysis (FEA) to compare the stress profiles of hemorrhagic and non-hemorrhagic profiles. Methods and Results:Forty-five consecutive patients who had suffered a cerebrovascular ischemic event with an underlying carotid artery disease underwent high-resolution magnetic resonance imaging (MRI) of their symptomatic carotid artery in a 1.5-T MRI system. Axial images were manually segmented for various plaque components and used for FEA. Maximum critical stress (M-CstressSL) for each slice was determined. Within a plaque, the maximum M-CstressSL for each slice of a plaque was selected to represent the maximum critical stress of that plaque (M-CstressPL) and used to compare hemorrhagic and non-hemorrhagic plaques. A total of 62% of plaques had hemorrhage. It was observed that plaques with hemorrhage had significantly higher stress (M-CstressPL) than plaques without PH ( Conclusions: Hemorrhagic plaques have higher biomechanical stresses than non-hemorrhagic plaques. MRIbased FEA seems to have the potential to assess plaque vulnerability. (Circ J 2011; 75: 884 - 889)

Plaque hemorrhage in carotid artery disease: Pathogenesis, clinical and biomechanical considerations

“…In a MRI-based study involving 45 symptomatic patients, the stress level over FC in 28 individuals with PH was significantly higher than those of asymptomatic patients (315 kPa [247–434] vs. 200 kPa [171–282]; p =0.003; median [inter quartile range]) (Sadat et al, 2011b). Similarly, Huang et al (2010) performed 3D FSI on 5 patients showing that stress over FC near PH was higher than those locations without PH (75.6 kPa vs. 68.1 kPa; p =0.0003).…”

Intracranial collateralization determines hemodynamic forces for carotid plaque disruption

“…There are several studies that provide evidence for the existence of intraplaque hemorrhage or lipid necrotic cores within carotid plaques. These are based on histology, 10,11,[16][17][18] ultrasound, 14,19 and magnetic resonance imaging 5,20,21 of the plaques. Large pressure drops across a stenosis can act directly, 22 or can apply shear stress to the plaque manifesting as tensile stress at the proximal edge or shear stress within the plaque, [23][24][25] to cause plaque disruption; while Bernoulli pressure depression due to high velocities within a stenosis may promote intraplaque hemorrhage.…”

Association of Age and Size of Carotid Artery Intraplaque Hemorrhage and Minor Fibrous Cap Disruption: A High Resolution Magnetic Resonance Imaging Study

“…The biomechanical propriety of IPH might play a role in the vulnerability of plaque surface 18 ) . It has been shown that IPH had a close connection with enhanced stress over fibrous cap 19 , 20 ) . According to previous investigators, because of the different ingredients appearing during aging of IPH, the mechanical impact of IPH on fibrous cap will change dynamically.…”