title: Functional assessment of the stenotic carotid artery by CFD-based pressure gradient evaluation.
abstract: The functional assessment of a hemodynamic significant stenosis base on blood pressure variation has been applied for evaluation of the myocardial ischemic event. This functional assessment shows great potential for improving the accuracy of the classification of the severity of carotid stenosis. To explore the value of grading the stenosis using a pressure gradient (PG)-we had reconstructed patient-specific carotid geometries based on MRI images-computational fluid dynamics were performed to analyze the PG in their stenotic arteries. Doppler ultrasound image data and the corresponding MRI image data of 19 patients with carotid stenosis were collected. Based on these, 31 stenotic carotid arterial geometries were reconstructed. A combinatorial boundary condition method was implemented for steady-state computer fluid dynamics simulations. Anatomic parameters, including tortuosity (T), the angle of bifurcation, and the cross-sectional area of the remaining lumen, were collected to investigate the effect on the pressure distribution. The PG is highly correlated with the severe stenosis (r = 0.902), whereas generally, the T and the angle of the bifurcation negatively correlate to the pressure drop of the internal carotid artery stenosis. The calculation required <10 min/case, which made it prepared for the fast diagnosis of the severe stenosis. According to the results, we had proposed a potential threshold value for distinguishing severe stenosis from mild-moderate stenosis (PG = 0.88). In conclusion, the PG could serve as the additional factor for improving the accuracy of grading the severity of the stenosis.
authors.affiliation: Institute of Clinical Anatomy, Southern Medical University, Guangzhou, China;
authors.forename: Xin
authors.initials: X
authors.lastname: Liu
authors.affiliation: Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Heye
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Neurology Department, Shenzhen Second People's Hospital, Shenzhen, Guangdon, China;
authors.forename: Lijie
authors.initials: L
authors.lastname: Ren
authors.affiliation: Department of Ultrasound, Shenzhen Second People's Hospital, Shenzhen, Guangdon, China; and.
authors.forename: Huahua
authors.initials: H
authors.lastname: Xiong
authors.affiliation: Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Zhifan
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Institute of Clinical Anatomy, Southern Medical University, Guangzhou, China;
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Xu
authors.affiliation: Institute of Clinical Anatomy, Southern Medical University, Guangzhou, China; 13822232749@139.com.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Huang
authors.affiliation: Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Wanqing
authors.initials: W
authors.lastname: Wu
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D057446:Hydrodynamics; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D018608:Ultrasonography, Doppler
keywords: carotid artery bifurcation; computational simulation; patient-specific geometry; pressure gradient; stenosis