Abstract

Atherosclerotic plaque rupture and progression have been the focus of intensive investigations in recent years. Plaque rupture is closely related to most severe cardiovascular syndromes such as heart attack and stroke. A computational procedure based on meshless generalized finite difference (MGFD) method and serial magnetic resonance imaging (MRI) data was introduced to quantify patient-specific carotid atherosclerotic plaque growth functions and simulate plaque progression. Participating patients were scanned three times (T(1), T(2), and T(3), at intervals of about 18 months) to obtain plaque progression data. Vessel wall thickness (WT) changes were used as the measure for plaque progression. Since there was insufficient data with the current technology to quantify individual plaque component growth, the whole plaque was assumed to be uniform, homogeneous, hyperelastic, isotropic and nearly incompressible. The linear elastic model was used. The 2D plaque model was discretized and solved using a meshless generalized finite difference (GFD) method. Starting from the T(2) plaque geometry, plaque progression was simulated by solving the solid model and adjusting wall thickness using plaque growth functions iteratively until T(3) is reached. Numerically simulated plaque progression agreed very well with actual plaque geometry at T(3) given by MRI data. We believe this is the first time plaque progression simulation based on multi-year patient-tracking data was reported. Serial MRI-based progression simulation adds time dimension to plaque vulnerability assessment and will improve prediction accuracy for potential plaque rupture risk.

Full Text
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