Blood Flow Pattern Analysis for Carotid Plaque Evaluation.
Koji Shimonaga1, Toshinori Matsushige1, Shigeyuki Sakamoto2
1Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Summary
Turbulent blood flow is common in carotid artery stenosis and linked to plaque vulnerability, including Gadolinium enhancement and ulceration. Real-time flow analysis aids in understanding plaque instability.
Area of Science:
- Cardiovascular Imaging
- Hemodynamics
- Vascular Biology
Background:
- Turbulent blood flow is implicated in plaque vulnerability.
- Two-dimensional (2D) real-time flow analysis offers novel insights into blood flow dynamics.
Purpose of the Study:
- To investigate the correlation between blood flow patterns and carotid plaque vulnerability.
- To evaluate the utility of 2D real-time flow analysis in assessing carotid artery stenosis.
Main Methods:
- 36 patients with cervical carotid artery stenosis underwent 2D real-time flow analysis using digital subtraction angiography (DSA).
- Flow patterns were classified as turbulent or laminar.
- Plaque vulnerability was assessed via MR imaging.
- Univariate analysis correlated flow patterns with plaque features.
Main Results:
- A turbulent flow pattern was observed in 77.8% of carotid plaques.
- Turbulence significantly correlated with Gadolinium enhancement (P=.0004), maximum stenosis (P=.0005), and ulceration (P=.02).
- No association was found between turbulent flow and clinical neurological symptoms.
Conclusions:
- The majority of carotid plaques exhibit turbulent flow, associated with indicators of vulnerability like Gadolinium enhancement and ulceration.
- Real-time flow analysis shows promise in elucidating the pathophysiology of plaque instability and ulcer formation.
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