title: Reconstruction of carotid bifurcation hemodynamics and wall thickness using computational fluid dynamics and MRI.
abstract: A thorough understanding of the relationship between local hemodynamics and plaque progression has been hindered by an inability to prospectively monitor these factors in vivo in humans. In this study a novel approach for noninvasively reconstructing artery wall thickness and local hemodynamics at the human carotid bifurcation is presented. Three-dimensional (3D) models of the lumen and wall boundaries, from which wall thickness can be measured, were reconstructed from black-blood magnetic resonance imaging (MRI). Along with time-varying inlet/outlet flow rates measured via phase contrast (PC) MRI, the lumen boundary was used as input for computational fluid dynamic (CFD) simulation of the subject-specific flow patterns and wall shear stresses (WSSs). Results from a 59-year-old subject with early, asymptomatic carotid artery disease show good agreement between simulated and measured velocities, and demonstrate a correspondence between wall thickening and low and oscillating shear at the carotid bulb. High shear at the distal internal carotid artery (ICA) was also colocalized with higher WSS; however, a quantitative general relationship between WSS and wall thickness was not found. Similar results were obtained from a 23-year-old normal subject. These findings represent the first direct comparison of hemodynamic variables and wall thickness at the carotid bifurcation of human subjects. The noninvasive nature of this image-based modeling approach makes it ideal for carrying out future prospective studies of hemodynamics and plaque development or progression in otherwise healthy subjects.
authors.affiliation: Imaging Research Labs, John P. Robarts Research Institute, London, Ontario, Canada. steinman@irus.rri.ca
authors.forename: David A
authors.initials: DA
authors.lastname: Steinman
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Thomas
authors.forename: Hanif M
authors.initials: HM
authors.lastname: Ladak
authors.forename: Jaques S
authors.initials: JS
authors.lastname: Milner
authors.forename: Brian K
authors.initials: BK
authors.lastname: Rutt
authors.forename: J David
authors.initials: JD
authors.lastname: Spence
mesh_terms: D000328:Adult; D002339:Carotid Arteries / Q000033:anatomy & histology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D002537:Intracranial Arteriosclerosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged