Self-corrected hemodynamic analysis of blood viscosity for detection of endothelial injury in atherosclerosis using magnetic resonance imaging

Carotid atherosclerosis remains a leading cause of stroke, where hemodynamic forces such as wall shear stress (WSS) plays a critical role in plaque formation. WSS strength depends on blood viscosity, yet current quantification methods neglect individual variations driven by metabolic disorders (e.g., diabetes and hyperlipidemia). This oversight masks early endothelial dysfunction preceding visible plaque formation. Herein, we propose an in vivo viscosity estimation framework, personalized blood viscosity (PBV), which integrates hemodynamic pressure-flow measurements and viscosity calculation. PBV-corrected WSS analysis demonstrates endothelial injury lesions in high-fat diet animals can be seen at 2–3 weeks before plaque formation. By linking the hyperlipidemia-driven viscosity shifts to WSS anomalies, this present study establishes a paradigm shift from geometric to personalized rheological assessment, suggesting a novel method for early atherosclerosis risk stratification in clinic.