Ultrasonography.  2021 Jul;40(3):428-441. 10.14366/usg.20131.

Stress distribution analysis in healthy and stenosed carotid artery models reconstructed from in vivo ultrasonography

Affiliations
  • 1Department of Medical Physics, Tarbiat Modares University, Tehran, Iran
  • 2Department of Medical Engineering, AmirKabir University of Technology, Tehran, Iran
  • 3Department of Radiology, Tehran Medical Sciences University, Imaging Center of Imam Khomeini Hospital, Tehran, Iran

Abstract

Purpose
This study investigated the accuracy of models reconstructed from ultrasound image processing by comparing the radial displacement waveforms of a subject-specific artery model and evaluated stress changes in the proximal shoulder, throat, and distal shoulder of the plaques depending on the degree of carotid artery stenosis.
Methods
Three groups of subjects (healthy and with less than 50% or more carotid stenosis) were evaluated with ultrasonography. Two-dimensional transverse imaging of the common carotid artery was performed to reconstruct the geometry. A longitudinal view of the same region was recorded to extract the Kelvin viscoelastic model parameters. The pulse pressure waveform and the effective pressure of perivascular tissue were loaded onto the internal and external walls of the model. Effective, circumferential, and principal stresses applied to the plaque throat, proximal shoulder, and distal shoulder in the transverse planes were extracted.
Results
The radial displacement waveforms of the model were closely correlated with those of image processing in all three groups. The mean of the effective, circumferential, and principal stresses of the healthy arteries were 15.01±4.93, 12.97±5.07, and 12.39±2.86 kPa, respectively. As stenosis increased from mild to significant, the mean values of the effective, circumferential, and first principal stresses increased significantly (97%, 74%, and 103% at the plaque throat, respectively) (P<0.05). The minimum effective stress was at the lipid pool. The effective stress in calcified areas was higher than in other parts of the artery wall.
Conclusion
This model can discriminate differences in stresses applied to mildly and severely stenotic plaques.

Keyword

Consecutive ultrasonic images; Carotid artery; Atherosclerotic plaque; Rupture; Finite element modeling; Viscoelastic model
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