中国临床医学影像杂志2024，Vol.35Issue(3)：186-191,6.DOI:10.12117/jccmi.2024.03.008
肾动脉粥样硬化斑块特征与血流动力学的关系及其对肾功能的影响
The relationship of hemodynamics with plaque characteristics and renal function of the stenotic renal artery based on computational fluid dynamics
摘要
Abstract
Objective:We aimed to investigate the relationship between computational fluid dynamics metric and anatomi-cal and morphological features of renal artery stenosis,and their efficacy in predicting impaired renal function.Methods:Re-nal artery CTA images of renal arteries in patients with moderate-to-severe unilateral renal atherosclerotic plaque from November 2021 to May 2023 were retrospectively analyzed to evaluaterenal artery plaque characteristics(degree of stenosis,maximum plaque thickness,plaque area,plaque volume,plaque burden,arterial remodeling and calcification)and cortical thickness difference(CTD).Hemodynamic parameters including time-averaged wall shear stress(TAWSS)and wall shear stress ratio(WSSR)across the lesion were evaluated by finite element software.Differences in plaque characteristics among different WSSR groups were compared,and the correlation with plaque characteristics was analyzed.Logistic regression analysis was used to evaluate independent risk factors for renal cortical thickness.Results:A total of 104 patients were included in the analysis.TAWSS in stenosis was higher than that in pre-stenotic and post-stenotic areas(P<0.001),and pre-stenotic TAWSS was higher than post-stenotic TAWSS(P<0.001).The stenosis severity,plaque burden and proportion of non-calcified plaque in the high WSSR group were higher than those in the low WSSR group(P=0.019,P=0.008,P=0.011).WSSR was positively cor-related with stenosis severity(r=0.028,P=0.02)and plaque burden(r=0.028,P=0.02).Plaque burden(OR 1.764;95%CI 1.008～8.087;P=0.047)and high WSSR(OR 3.047;95%CI 1.123～8.262;P=0.029)were independently associated with high CTD.The AUC of high CDT predicted by the combination of the two parameters is 0.72.Conclusion:WSSR and plaque characteristics may provide important parameters to reflect renal function after renal artery stenosis.Plaque burden and high WSSR can pre-dict the degree of renal function impairment.关键词
斑块,动脉粥样硬化/肾动脉/计算机体层摄影血管造影术Key words
Plaque,Atherosclerotic/Renal Artery/Computed Tomography Angiography分类
医药卫生引用本文复制引用
李笑天,王慧颖,赵玉娇,赵雨蒙,秦佳明,张程,陈丽华,夏爽,沈文..肾动脉粥样硬化斑块特征与血流动力学的关系及其对肾功能的影响[J].中国临床医学影像杂志,2024,35(3):186-191,6.基金项目
国家自然科学基金项目(82271971) （82271971）
天津市医学重点学科(专科)建设项目(TJYXZDXK-041A) （专科）
天津市科委自然科学基金项目(21JCYBTC01640). （21JCYBTC01640）
