Time-efficient patient-specific quantification of regional carotid artery fluid dynamics and spatial correlation with plaque burden

Methods: Eight patients (68 +/- 9 yr, one female) underwent multicontrast 3 T MRI at baseline and six-month post statin treatment. PT and PC were measured in carotid segments (common-CC, bifurcation-B, internal-IC) and circumferentially in nonoverlapping 60 degrees angles and correlated with CFD models created from MRI, ultrasound, and blood pressure. Results: PT was highest in B (2.42 +/- 0.98 versus CC: 1.60 +/- 0.47, IC: 1.62 +/- 0.52 mm, p < 0.01). Circumferentially, plaque was greatest opposite the flow divider (p < 0.01), where the lowest WSS and highest OSI were observed. In B and IC, PT was inversely related to WSS (R=-0.28 and -0.37, p < 0.01) and directly related to OSI (R=0.22 and 0.52, p < 0.05). The total plaque volume changed from 1140 +/- 437 to 974 +/- 587 mm(3) at six months (p=0.1). Baseline WSS, but not OSI, correlated with changes in PT, necrotic tissue, and hemorrhage in B and IC, but not CC. CFD modeling took 49 +/- 18 h per patient. Conclusions: PT and PC correspond to adverse WSS and OSI in B and IC, and WSS is modestly but significantly related to changes in PT after short-term statin treatment. Regional hemodynamics from CFD can feasibly augment routine clinical imaging for comprehensive plaque evaluation.