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Published byMaximillian Bond Modified over 5 years ago
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Structural analysis and magnetic resonance imaging predict plaque vulnerability: A study comparing symptomatic and asymptomatic individuals Zhi-Yong Li, PhD, Simon P.S. Howarth, MRCS, Tjun Tang, MRCS, Martin J. Graves, MSc, Jean U-King-Im, MRCS, Rikin A. Trivedi, PhD, MRCS, MRCP, Peter J. Kirkpatrick, FmedSci, FRCS (SN), Jonathan H. Gillard, MD, FRCR Journal of Vascular Surgery Volume 45, Issue 4, Pages (April 2007) DOI: /j.jvs Copyright © 2007 The Society for Vascular Surgery Terms and Conditions
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Fig 1 Correlation of the location between maximum stress concentration and plaque rupture in a symptomatic plaque. A, T2-weighted magnetic resonance image. B, Insert shows fibrous cap (white arrows) and the lipid pool (yellow star). C, Histologic sample stained with elastic van Gieson and hematoxylin and eosin demonstrate a complex plaque with rupture (red arrow) of the fibrous cap (black arrow). D, Computed stress map shows high stress in the plaque rupture region (red arrow). A high stress concentration is likewise predicted opposite this region in relatively normal vessel wall. Although this may be mechanically present, it is unlikely to be of pathologic importance. Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions
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Fig 2 High stress concentrations at the shoulder regions of a plaque with 50% luminal stenosis. The plaque has a very thin fibrous cap covering a relatively large amount of lipid core. Left, Intermediate T2-weighted sequence shows the fibrous cap (white arrowhead) and the lipid pool (yellow star). Right, Computed stress map shows high stress in the plaque shoulders (red arrows). Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions
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Fig 3 Comparison between symptomatic and asymptomatic subjects shows magnetic resonance image, plaque geometries, and computed stress maps for both plaques. High maximal stress can be clearly seen at the shoulder region of the symptomatic plaque (yellow arrow). Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions
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Fig 4 Box and whisker plot shows median peak stress (black bar), interquartile ranges (whiskers), and outliers (circles) in the two groups. The maximal stresses predicted in symptomatic group were significantly higher than those predicted in the asymptomatic group (508.2 ± vs ± kPa; P = .004). Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions
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