BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imag...BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging(HR-VWI).AIM To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.METHODS Ninety-four patients diagnosed with middle cerebral artery or basilar artery INTRODUCTION Intracranial atherosclerotic disease is one of the main causes of ischaemic stroke in the world,accounting for approx-imately 10%of transient ischaemic attacks and 30%-50%of ischaemic strokes[1].It is the most common factor among Asian people[2].The adaptive changes in the structure and function of blood vessels that can adapt to changes in the internal and external environment are called vascular remodelling,which is a common and important pathological mechanism in atherosclerotic diseases,and the remodelling mode of atherosclerotic plaques is closely related to the occurrence of stroke.Positive remodelling(PR)is an outwards compensatory remodelling where the arterial wall grows outwards in an attempt to maintain a constant lumen diameter.For a long time,it was believed that the degree of stenosis can accurately reflect the risk of ischaemic stroke[3-5].Previous studies have revealed that lesions without significant luminal stenosis can also lead to acute events[6,7],as summarized in a recent meta-analysis study in which approximately 50%of acute/subacute ischaemic events were due to this type of lesion[6].Research[8,9]has pointed out that the PR of plaques is more dangerous and more likely to cause acute ischaemic stroke.Previous studies[10-13]have found that there are specific vascular remodelling phenomena in the coronary and carotid arteries of diabetic patients.However,due to the deep location and small lumen of intracranial arteries and limitations of imaging techniques,the relationship between intracranial arterial remodelling and diabetes is still unclear.In recent years,with the development of magnetic resonance technology and the emergence of high-resolution(HR)vascular wall imaging,a clear and multidimensional display of the intracranial vascular wall has been achieved.Therefore,in this study,HR wall imaging(HR-VWI)was used to display the remodelling characteristics of bilateral middle cerebral arteries and basilar arteries and to explore the factors of intracranial vascular remodelling and its relationship with diabetes.展开更多
AIM:To evaluate a high-resolution functional imaging device that yields quantitative data regarding macular blood flow and capillary network features in eyes with diabetic retinopathy(DR).METHODS:Prospective,cross-sec...AIM:To evaluate a high-resolution functional imaging device that yields quantitative data regarding macular blood flow and capillary network features in eyes with diabetic retinopathy(DR).METHODS:Prospective,cross-sectional comparative case-series in which blood flow velocities(BFVs)and noninvasive capillary perfusion maps(nCPMs)in macular vessels were measured in patients with DR and in healthy controls using the Retinal Functional Imager(RFI)device.RESULTS:A total of 27 eyes of 21 subjects were studied[9 eyes nonproliferative diabetic retinopathy(NPDR),9 eyes proliferative diabetic retinopathy(PDR)and 9 controls].All diabetic patients were type 2.All patients with NPDR and 5 eyes with PDR also had diabetic macular edema(DME).The NPDR group included eyes with severe(n=3)and moderate NPDR(n=6),and were symptomatic.A significant decrease in venular BFVs was observed in the macular region of PDR eyes when compared to controls(2.61±0.6 mm/s and 2.92±0.72 mm/s in PDR and controls,respectively,P=0.019)as well as PDR eyes with DME compared to NPDR eyes(2.36±0.51 mm/s and 2.94±1.09 mm/s in PDR with DME and NPDR,respectively,P=0.01).CONCLUSION:The RFI,a non-invasive imaging tool,provides high-resolution functional imaging of the retinal microvasculature and quantitative measurement of BFVs in visually impaired DR patients.The isolated diminish venular BFVs in PDR eyes compared to healthy eyes and PDR eyes with DME in comparison to NPDR eyes may indicate the possibility of more retinal vein compromise than suspected in advanced DR.展开更多
In vivo studies on association between wall shear stress(WSS)and intracranial plaque are deficient.Based on the three-dimensional T1-weighted high-resolution magnetic resonance imaging(3DT1 HR-MRI)data of patients wit...In vivo studies on association between wall shear stress(WSS)and intracranial plaque are deficient.Based on the three-dimensional T1-weighted high-resolution magnetic resonance imaging(3DT1 HR-MRI)data of patients with low-grade stenotic(<50%)atherosclerotic middle cerebral artery(MCA)and subjects with normal MCA,we built a three-dimensional reconstructed WSS model by computational fluid dynamics(CFD)technique.Three-dimensional registration of the CFD model to the HR-MRI was performed with projections based on the resolution and thickness of the images.The relationships between the Wss at each side of the vessel wall and plaque location were analyzed.A total of 94 MCA plaques from 43 patients and 50 normal MCAs were analyzed.In the normal MCAs,WSS was lower at the ventral-inferior wall than at the dorsal-superior wall(proximal segment,p<0.001;middle segment,p<0.001)and lower at the inner wall than at the outer wall of the MCA curve(p<0.001).In atherosclerotic MCAs,similar low Wss regions were observed where plaques developed.The WSS ratio of the ventral-inferior wall to the dorsal-superior wall in atherosclerotic MCAs was lower than that in normal MCAs(p=0.002).The WSS_(inmer-outer)ratio in atherosclerotic MCAs was lower than that in normal MCAs(p=0.002).Low WSS was associated with MCA atherosclerosis formation and occurred mainly at the ventral inferior wall,which was anatomically opposite the orifices of penetrating arteries,and at the inner wall of the MCA curve.Overall,the results were well consistent with the low WSS theory in atherosclerosis formation.The reconstructed WSS model is a promising novel method for assessing an individualized vascular profile once validated by further studies.展开更多
基金Supported by National Natural Science Foundation of China,No.82071871Guangdong Basic and Applied Basic Research Foundation,No.2021A1515220131+1 种基金Guangdong Medical Science and Technology Research Fund Project,No.2022111520491834Clinical Research Project of Shenzhen Second People's Hospital,No.20223357022。
文摘BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging(HR-VWI).AIM To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.METHODS Ninety-four patients diagnosed with middle cerebral artery or basilar artery INTRODUCTION Intracranial atherosclerotic disease is one of the main causes of ischaemic stroke in the world,accounting for approx-imately 10%of transient ischaemic attacks and 30%-50%of ischaemic strokes[1].It is the most common factor among Asian people[2].The adaptive changes in the structure and function of blood vessels that can adapt to changes in the internal and external environment are called vascular remodelling,which is a common and important pathological mechanism in atherosclerotic diseases,and the remodelling mode of atherosclerotic plaques is closely related to the occurrence of stroke.Positive remodelling(PR)is an outwards compensatory remodelling where the arterial wall grows outwards in an attempt to maintain a constant lumen diameter.For a long time,it was believed that the degree of stenosis can accurately reflect the risk of ischaemic stroke[3-5].Previous studies have revealed that lesions without significant luminal stenosis can also lead to acute events[6,7],as summarized in a recent meta-analysis study in which approximately 50%of acute/subacute ischaemic events were due to this type of lesion[6].Research[8,9]has pointed out that the PR of plaques is more dangerous and more likely to cause acute ischaemic stroke.Previous studies[10-13]have found that there are specific vascular remodelling phenomena in the coronary and carotid arteries of diabetic patients.However,due to the deep location and small lumen of intracranial arteries and limitations of imaging techniques,the relationship between intracranial arterial remodelling and diabetes is still unclear.In recent years,with the development of magnetic resonance technology and the emergence of high-resolution(HR)vascular wall imaging,a clear and multidimensional display of the intracranial vascular wall has been achieved.Therefore,in this study,HR wall imaging(HR-VWI)was used to display the remodelling characteristics of bilateral middle cerebral arteries and basilar arteries and to explore the factors of intracranial vascular remodelling and its relationship with diabetes.
文摘AIM:To evaluate a high-resolution functional imaging device that yields quantitative data regarding macular blood flow and capillary network features in eyes with diabetic retinopathy(DR).METHODS:Prospective,cross-sectional comparative case-series in which blood flow velocities(BFVs)and noninvasive capillary perfusion maps(nCPMs)in macular vessels were measured in patients with DR and in healthy controls using the Retinal Functional Imager(RFI)device.RESULTS:A total of 27 eyes of 21 subjects were studied[9 eyes nonproliferative diabetic retinopathy(NPDR),9 eyes proliferative diabetic retinopathy(PDR)and 9 controls].All diabetic patients were type 2.All patients with NPDR and 5 eyes with PDR also had diabetic macular edema(DME).The NPDR group included eyes with severe(n=3)and moderate NPDR(n=6),and were symptomatic.A significant decrease in venular BFVs was observed in the macular region of PDR eyes when compared to controls(2.61±0.6 mm/s and 2.92±0.72 mm/s in PDR and controls,respectively,P=0.019)as well as PDR eyes with DME compared to NPDR eyes(2.36±0.51 mm/s and 2.94±1.09 mm/s in PDR with DME and NPDR,respectively,P=0.01).CONCLUSION:The RFI,a non-invasive imaging tool,provides high-resolution functional imaging of the retinal microvasculature and quantitative measurement of BFVs in visually impaired DR patients.The isolated diminish venular BFVs in PDR eyes compared to healthy eyes and PDR eyes with DME in comparison to NPDR eyes may indicate the possibility of more retinal vein compromise than suspected in advanced DR.
基金This work was supported by the National Science Fund for Distinguished Young Scholars(Grant No.8202500477)the National Natural Science Foundation of China(Grants No.81471207,81671370,81661168015)2016 PUMCH science fund for junior faculty,and Shenzhen Science and Technology Innovation Commission(Grant No.JCYJ20160608153506088).
文摘In vivo studies on association between wall shear stress(WSS)and intracranial plaque are deficient.Based on the three-dimensional T1-weighted high-resolution magnetic resonance imaging(3DT1 HR-MRI)data of patients with low-grade stenotic(<50%)atherosclerotic middle cerebral artery(MCA)and subjects with normal MCA,we built a three-dimensional reconstructed WSS model by computational fluid dynamics(CFD)technique.Three-dimensional registration of the CFD model to the HR-MRI was performed with projections based on the resolution and thickness of the images.The relationships between the Wss at each side of the vessel wall and plaque location were analyzed.A total of 94 MCA plaques from 43 patients and 50 normal MCAs were analyzed.In the normal MCAs,WSS was lower at the ventral-inferior wall than at the dorsal-superior wall(proximal segment,p<0.001;middle segment,p<0.001)and lower at the inner wall than at the outer wall of the MCA curve(p<0.001).In atherosclerotic MCAs,similar low Wss regions were observed where plaques developed.The WSS ratio of the ventral-inferior wall to the dorsal-superior wall in atherosclerotic MCAs was lower than that in normal MCAs(p=0.002).The WSS_(inmer-outer)ratio in atherosclerotic MCAs was lower than that in normal MCAs(p=0.002).Low WSS was associated with MCA atherosclerosis formation and occurred mainly at the ventral inferior wall,which was anatomically opposite the orifices of penetrating arteries,and at the inner wall of the MCA curve.Overall,the results were well consistent with the low WSS theory in atherosclerosis formation.The reconstructed WSS model is a promising novel method for assessing an individualized vascular profile once validated by further studies.
