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Updated: Aug 31, 2025
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Slice-based and time-specific hemodynamic measurements discriminate carotid artery vulnerable atherosclerotic plaques
Rui Shen1, Xinyu Tong2, Dongye Li3
1Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
Insights
Slice-based and time-specific hemodynamic measurements, like time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI), effectively identify carotid intra-plaque hemorrhage (IPH). Combining these with plaque burden improves discrimination of vulnerable carotid plaques.
Area of Science:
- Cardiovascular Imaging
- Biomedical Engineering
- Medical Diagnostics
Background:
- Hemodynamic patterns are crucial in carotid vulnerable plaque progression.
- Traditional hemodynamic measurements (max/average values) inadequately represent complex patterns.
- Slice-based and time-specific hemodynamic data offer a more nuanced understanding.
Purpose of the Study:
- To investigate the association between slice-based, time-specific hemodynamic measurements and carotid vulnerable plaques.
- To utilize magnetic resonance (MR) vessel wall imaging and histology for plaque evaluation.
- To identify specific hemodynamic parameters linked to vulnerable plaque features.
Main Methods:
- Thirty-two patients with significant carotid stenosis underwent MR vessel wall imaging.
- Histology identified vulnerable plaque features, including intra-plaque hemorrhage (IPH).
- Computational fluid dynamics simulations generated slice-based and time-specific hemodynamic data (TAWSS, OSI, peakWSS).
Main Results:
- TAWSS, OSI, and peakWSS showed significant associations with carotid IPH.
- Logistic regression confirmed peakWSS and TAWSS as significant predictors of IPH.
- Combined hemodynamic measurements with maximum wall thickness demonstrated superior discrimination of IPH.
Conclusions:
- Slice-based and time-specific hemodynamic characteristics effectively discriminate carotid IPH.
- Combining hemodynamic data with carotid plaque burden enhances the identification of vulnerable plaque features.
- This approach offers a more robust method for assessing carotid plaque vulnerability.
Background And Objective:
Hemodynamic patterns play key roles in progression of carotid vulnerable plaques. However, most of previous studies utilized maximum or averaged value of hemodynamic measurements which is not an ideal representative of hemodynamic patterns. This study aimed to investigate the association of slice-based and time-specific hemodynamic measurements with carotid vulnerable plaque using magnetic resonance (MR) vessel wall imaging and histology.
Methods:
Thirty-two patients (mean age: 63.9±8.1 years; 25 males) with carotid atherosclerotic stenosis (≥50% stenosis) referred to carotid endarterectomy were recruited and underwent MR vessel wall imaging. Carotid plaque burden was evaluated on MR images and vulnerable plaque features including calcification, lipid-rich necrotic core, and intra-plaque hemorrhage (IPH) were identified by histology. The slice-based and time-specific hemodynamic measurements were extracted from computational fluid dynamics simulation of 3D carotid arterial model. Correlation coefficients between hemodynamic measurements and carotid plaque features were calculated and the logistic regressions with generalized estimating equation (GEE) were conducted. The value in discriminating carotid vulnerable plaque features was determined by receiver-operating-characteristic analysis.
Results:
Of 102 MR-histology matched slices from 32 patients, time-averaged wall shear stress (TAWSS) (r=0.263, p=0.008), oscillatory shear index (OSI) (r=-0.374, p<0.001), and peakWSS (r=0.232, p=0.019) were significantly associated with carotid IPH. The logistic regression with GEE revealed that peakWSS (OR, 1.206; 95% CI, 1.026-1.418; p, 0.023) and TAWSS (OR, 0.364, 95% CI, 0.138-0.959; p, 0.041) were significantly associated with presence of IPH after adjusting for age and BMI. In discriminating carotid IPH, the AUC of TAWSS, OSI, combined TAWSS with maximum wall thickness (MWT) and combined OSI with MWT was 0.656, 0.722, 0.761, and 0.764, respectively.
Conclusions:
Slice-based and time-specific hemodynamic characteristics could effectively discriminate carotid IPH. Combination of hemodynamic measurements with carotid plaque burden might be a stronger indicator for carotid vulnerable plaque features than each measurement alone.
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