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Zhang D, Wu X, Tang J, et al. Hemodynamics is associated with vessel wall remodeling in patients with middle cerebral artery stenosis. Eur Radiol. 2021;31(7):5234-5242doi: 10.1007/s00330-020-07607-w.
Zhang, D., Wu, X., Tang, J., Wang, P., Chen, G. Z., & Yin, X. (2021). Hemodynamics is associated with vessel wall remodeling in patients with middle cerebral artery stenosis. European radiology, 31(7), 5234-5242. https://doi.org/10.1007/s00330-020-07607-w
Zhang, Danfeng, et al. "Hemodynamics is associated with vessel wall remodeling in patients with middle cerebral artery stenosis." European radiology vol. 31,7 (2021): 5234-5242. doi: https://doi.org/10.1007/s00330-020-07607-w
Zhang D, Wu X, Tang J, Wang P, Chen GZ, Yin X. Hemodynamics is associated with vessel wall remodeling in patients with middle cerebral artery stenosis. Eur Radiol. 2021 Jul;31(7):5234-5242. doi: 10.1007/s00330-020-07607-w. Epub 2021 Jan 13. PMID: 33439317.
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Eur Radiol. 2021 Jul;31(7):5234-5242. doi: 10.1007/s00330-020-07607-w. Epub 2021 Jan 13.

Hemodynamics is associated with vessel wall remodeling in patients with middle cerebral artery stenosis.

European radiology

Danfeng Zhang, Xinying Wu, Jie Tang, Peng Wang, Guo Zhong Chen, Xindao Yin

Affiliations

  1. Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, China.
  2. Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, China. [email protected].
  3. Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, China. [email protected].

PMID: 33439317 DOI: 10.1007/s00330-020-07607-w

Abstract

OBJECTIVES: To evaluate the relationship between hemodynamics and vessel wall remodeling patterns in middle cerebral artery (MCA) stenosis based on high-resolution magnetic resonance imaging and computational fluid dynamics (CFD).

METHODS: Forty consecutive patients with recent ischemic stroke or transient ischemic attack attributed to unilateral atherosclerotic MCA stenosis (50-99%) were prospectively recruited. All patients underwent a cross-sectional scan of the stenotic MCA vessel wall. The parameters of the vessel wall, the number of patients with acute infarction, translesional wall shear stress ratio (WSSR), wall shear stress in stenosis (WSSs), and translesional pressure ratio were obtained. The patients were divided into positive remodeling (PR) and negative remodeling (NR) groups. The differences in vessel wall parameters and hemodynamics were compared. Correlations between the parameters of the vessel wall and hemodynamics were calculated.

RESULTS: Of the 40 patients, 16 had PR, 19 had NR, and the other 5 displayed non-remodeling. The PR group had a smaller lumen area (p = 0.004), larger plaque area (p < 0.001), normal wall index (p = 0.004), and higher WSSR (p = 0.004) and WSSs (p = 0.023) at the most narrowed site. The PR group had more enhanced plaques (12 vs 6, p = 0.03). The number of patients with acute stroke in the PR group was more than that in the NR group (11 vs 4, p = 0.01). The remodeling index (r = 0.376, p = 0.026) and plaque area (r = 0.407, p = 0.015) showed a positive correlation with WSSR, respectively.

CONCLUSIONS: Hemodynamics plays a role in atherosclerotic plaques and vessel wall remodeling. Individuals with greater hemodynamic values might be more prone to stroke.

KEY POINTS: • Stenotic plaques in middle cerebral artery with positive remodeling have smaller lumen area and larger resp. higher plaque area, normal wall index, translesional wall shear stress ratio, and wall shear stress than negative remodeling. • The remodeling index and plaque area are positively correlated with translesional wall shear stress ratio. • Hemodynamic may help to understand the role of positive remodeling in the development of acute stroke.

Keywords: Hemodynamics; Magnetic resonance imaging; Shear strength; Vascular remodeling

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