Date Published: June 6, 2019
Publisher: Public Library of Science
Author(s): A. M. Moerman, K. Dilba, S. Korteland, D. H. J. Poot, S. Klein, A. van der Lugt, E. V. Rouwet, K. van Gaalen, J. J. Wentzel, A. F. W. van der Steen, F. J. H. Gijsen, K. Van der Heiden, Dalin Tang.
Wall shear stress (WSS), the frictional force exerted on endothelial cells by blood flow, is hypothesised to influence atherosclerotic plaque growth and composition. We developed a methodology for image registration of MR and histology images of advanced human carotid plaques and corresponding WSS data, obtained by MRI and computational fluid dynamics.
Atherosclerosis is a progressive vascular disease, characterised by the accumulation of lipids and inflammatory cells in the vessel wall, which results in plaque formation. A subset of atherosclerotic plaques is prone to rupture [1–3]. A rupture-prone, vulnerable plaque differs compositionally from a stable plaque, and is characterised by a large lipid core covered by a thin fibrous cap, inflammatory cell infiltration and/or intraplaque haemorrhage. In the event of rupture, plaque- and thrombus material may embolise into the distally located vessel bed. Depending on the anatomical location of the plaque, rupture might lead to stroke or acute myocardial infarction. Unravelling the mechanisms behind plaque destabilisation, leading to a rupture-prone plaque, is thus of high importance.
We developed the first MRI-based pipeline to register WSS data to histology images. This method enables patient-specific investigation of correlations between WSS and histology-based plaque composition. We demonstrated that a mismatch of one slice does not significantly affect WSS distribution or the relation between WSS and plaque thickness.