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Zhang W, Huang C, Yin T, Miao X, Deng H, Zheng R, Ren J, Chen S. Ultrasensitive US Microvessel Imaging of Hepatic Microcirculation in the Cirrhotic Rat Liver. Radiology 2022; 307:e220739. [PMID: 36413130 DOI: 10.1148/radiol.220739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Liver microcirculation dysfunction plays a vital role in the occurrence and development of liver diseases, and thus, there is a clinical need for in vivo, noninvasive, and quantitative evaluation of liver microcirculation. Purpose To evaluate the feasibility of ultrasensitive US microvessel imaging (UMI) in the visualization and quantification of hepatic microvessels in healthy and cirrhotic rats. Materials and Methods In vivo studies were performed to image hepatic microvasculature by means of laparotomy in Sprague-Dawley rats (five cirrhotic and five control rats). In vivo conventional power Doppler US and ex vivo micro-CT were performed for comparison. UMI-based quantifications of perfusion, tortuosity, and integrity of microvessels were compared between the control and cirrhotic groups by using the Wilcoxon test. Spearman correlations between quantification parameters and pathologic fibrosis, perfusion function, and hepatic hypoxia were evaluated. Results UMI helped detect minute vessels below the liver capsule, as compared with conventional power Doppler US and micro-CT. With use of UMI, lower perfusion indicated by vessel density (median, 22% [IQR, 20%-28%] vs 41% [IQR, 37%-46%]; P = .008) and fractional moving blood volume (FMBV) (median, 6.4% [IQR, 4.8%-8.6%] vs 13% [IQR, 12%-14%]; P = .008) and higher tortuosity indicated by the sum of angles metric (SOAM) (median, 3.0 [IQR, 2.9-3.0] vs 2.7 [IQR, 2.6-2.9]; P = .008) were demonstrated in the cirrhotic rat group compared with the control group. Vessel density (r = 0.85, P = .003), FMBV (r = 0.86, P = .002), and median SOAM (r = -0.83, P = .003) showed strong correlations with pathologically derived vessel density labeled with dextran. Vessel density (r = -0.81, P = .005) and median SOAM (r = 0.87, P = .001) also showed strong correlations with hepatic tissue hypoxia. Conclusion Contrast-free ultrasensitive US microvessel imaging provided noninvasive in vivo imaging and quantification of hepatic microvessels in cirrhotic rat liver. © RSNA, 2022 Supplemental material is available for this article. See also the editorial by Fetzer in this issue.
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Affiliation(s)
- Wei Zhang
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Chengwu Huang
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Tinghui Yin
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Xiaoyan Miao
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Huan Deng
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Rongqin Zheng
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Jie Ren
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Shigao Chen
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
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Tang S, Huang C, Gong P, Lok UW, Zhou C, Yang L, Knoll KM, Robinson KA, Sheedy SP, Fletcher JG, Bruining DH, Knudsen JM, Chen S. Adaptive and Robust Vessel Quantification in Contrast-Free Ultrafast Ultrasound Microvessel Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:2095-2109. [PMID: 35882573 PMCID: PMC9427726 DOI: 10.1016/j.ultrasmedbio.2022.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 04/09/2022] [Accepted: 05/29/2022] [Indexed: 02/05/2023]
Abstract
The morphological features of vasculature in diseased tissue differ significantly from those in normal tissue. Therefore, vasculature quantification is crucial for disease diagnosis and staging. Ultrasound microvessel imaging (UMI) with ultrafast ultrasound acquisitions has been determined to have potential in clinical applications given its superior sensitivity in blood flow detection. However, the presence of spatial-dependent noise caused by a low imaging signal-to-noise ratio and incoherent clutter artifacts caused by moving hyperechoic scatterers degrades the performance of UMI and the reliability of vascular quantification. To tackle these issues, we proposed an improved UMI technique along with an adaptive vessel segmentation workflow for robust vessel identification and vascular feature quantification. A previously proposed sub-aperture cross-correlation technique and a normalized cross-correlation technique were applied to equalize the spatially dependent noise level and suppress the incoherent clutter artifact. A square operator and non-local means filter were then used to better separate the blood flow signal from residual background noise. On the de-noised ultrasound microvessel image, an automatic and adaptive vessel segmentation method was developed based on the different spatial patterns of blood flow signal and background noise. The proposed workflow was applied to a CIRS phantom, to a Doppler flow phantom and to an inflammatory bowel, kidney and liver, to validate its feasibility. Results revealed that automatic adaptive, and robust vessel identification performance can be achieved using the proposed method without the subjectivity caused by radiologists/operators.
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Affiliation(s)
- Shanshan Tang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Chengwu Huang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ping Gong
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - U-Wai Lok
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Chenyun Zhou
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lulu Yang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Kate M Knoll
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Joel G Fletcher
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - David H Bruining
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - John M Knudsen
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Shigao Chen
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
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Chen WJ, Luo LL, Dong ZX, Wu J, Gu XX, Bian ZL. Application of transabdominal ultrasound in Crohn's disease. Shijie Huaren Xiaohua Zazhi 2022; 30:364-369. [DOI: 10.11569/wcjd.v30.i8.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Crohn's disease (CD), a chronic nonspecific intestinal inflammatory disorder of uncertain origin, is collectively referred to as inflammatory bowel disease with ulcerative colitis. In recent years, with the increasing incidence of CD, a greater demand has been put forward for disease diagnosis and inflammatory activity monitoring. With the development of ultrasound technology, transabdominal ultrasound has become more relevant for the diagnosis and follow-up of CD, providing an effective non-invasive examination tool for patients. This review summarizes several transabdominal ultrasound modalities and associated techniques that are presently being developed and utilized in clinical practice, describes the ultrasound manifestations of CD, and discusses the value and prospect of transabdominal ultrasonography in CD.
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Affiliation(s)
- Wei-Jie Chen
- Nantong University, Nantong 226001, Jiangsu Province, China
| | - Lei-Lei Luo
- Department of Gastroenterology, Affiliated Nantong Third Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Zhi-Xing Dong
- Nantong University, Nantong 226001, Jiangsu Province, China
| | - Jing Wu
- Department of Gastroenterology, Affiliated Nantong Third Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Xing-Xing Gu
- Department of Gastroenterology, Affiliated Nantong Third Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Zhao-Lian Bian
- Department of Gastroenterology, Affiliated Nantong Third Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
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Ferretti F, Cannatelli R, Ardizzone S, Maier JA, Maconi G. Ultrasonographic Evaluation of Intestinal Fibrosis and Inflammation in Crohn's Disease. The State of the Art. Front Pharmacol 2021; 12:679924. [PMID: 33981246 PMCID: PMC8107820 DOI: 10.3389/fphar.2021.679924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/09/2021] [Indexed: 12/16/2022] Open
Abstract
The evaluation of the degree of inflammation and fibrosis, intrinsic elements in intestinal wall damage of Crohn’s disease, is essential to individuate the extent of the lesions and the presence of strictures. This information will contribute to the choice of the appropriate therapeutic approach, the prediction of the response to therapy and the course of the disease. The accurate evaluation of the extent and severity of inflammation and/or fibrosis in Crohn’s disease currently requires histopathological analysis of the intestinal wall. However, in clinical practice and research, transmural assessment of the intestinal wall with cross sectional imaging is increasingly used for this purpose. The B-mode ultrasonograhic characteristics of the intestinal wall, the assessment of its vascularization by color Doppler and I.V. contrast agents, and the evaluation of the mechanical and elastic properties by sonoelastography, may provide useful and accurate information on the severity and extent of inflammation and intestinal fibrosis in Crohn’s disease. The purpose of this review is to provide an update on current sonographic methods to discriminate inflammation and fibrosis in Crohn’s disease.
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Affiliation(s)
- Francesca Ferretti
- Gastroenterology Unit-ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Rosanna Cannatelli
- Gastroenterology Unit-ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Sandro Ardizzone
- Gastroenterology Unit-ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Jeanette A Maier
- General Pathology-Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Maconi
- Gastroenterology Unit-ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
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