Korean J Radiol.  2011 Aug;12(4):515-518. 10.3348/kjr.2011.12.4.515.

High Shear Stress at the Surface of Enhancing Plaque in the Systolic Phase is Related to the Symptom Presentation of Severe M1 Stenosis

• Suh DC
• Park ST
• Oh TS
• Park SO
• Lim OK
• Park S
• Ryu CW
• Lee DH
• Ko YB
• Lee SW
• Yoon K
• Kim JS

• KMID: 1783220
• DOI: http://doi.org/10.3348/kjr.2011.12.4.515

Abstract

The computational fluid dynamics methods for the limited flow rate and the small dimensions of an intracranial artery stenosis may help demonstrate the stroke mechanism in intracranial atherosclerosis. We have modeled the high wall shear stress (WSS) in a severe M1 stenosis. The high WSS in the systolic phase of the cardiac cycle was well-correlated with a thick fibrous cap atheroma with enhancement, as was determined using high-resolution plaque imaging techniques in a severe stenosis of the middle cerebral artery.

Keyword

Cerebral artery; Atherosclerosis; MRI, Plaque rupture, Fluid structure interaction

MeSH Terms

Blood Flow Velocity
*Cerebral Angiography
Cerebrovascular Circulation
Computational Biology
Humans
Image Interpretation, Computer-Assisted
Imaging, Three-Dimensional
Intracranial Arteriosclerosis/*diagnosis
*Magnetic Resonance Angiography
Shear Strength
Software
Systole

Figure

• 

  Fig. 1 Computational fluid dynamics study in severe M1 stenosis with enhanced plaque seen on high resolution MRI. Diffusion-weighted image (A) shows perforator and borderzone infarcts (arrow) in 55-year-old male who presented with right hemiparesis and aphasia. Coronal reconstituted pre- (B) and post- (C) Gadolinium enhanced high resolution MR images shows eccentric plaque with enhancement of thick fibrous cap atheroma, which may explain mechanism of stroke as having arisen from surface erosion for borderzone infarcts and plaque encroachment for perforator infarct. CFD obtained from 3D angiography (D) reveals increased wall shear stress (E). Distribution of wall shear stress showed that highest wall shear stress was present during systolic phase (not shown). Fusion image (F) reveals markedly increased wall shear stress at upstream side of enhancing plaque, as determined by CFD. CFD = computational fluid dynamics.

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