Can We Use In Vivo MRI and FEA to Determine Peak Cap Stress in Carotid Plaques? MRI Simulations Provide Answers

Vulnerable plaques are characterized by a large lipid-rich necrotic core (LRNC) separated by a thin fibrous cap (FC) from the lumen. Plaque rupture occurs when the peak stress in the FC exceeds its strength. Carotid in vivo magnetic resonance imaging (MRI) data can be segmented to obtain the plaque geometry noninvasively. An increasing number of studies use MR imaging for biomechanical finite element analysis (FEA) to compute peak cap stresses [1, 2]. Previous studies have shown that the thickness of the FC is an important determinant of peak cap stress: the thinner the FC, the higher the stress, the higher the plaque rupture risk [3].