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Kim DA, Ku DN. Material strengths of shear-induced platelet aggregation clots and coagulation clots. Sci Rep 2024; 14:11460. [PMID: 38769378 PMCID: PMC11106319 DOI: 10.1038/s41598-024-62165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 05/14/2024] [Indexed: 05/22/2024] Open
Abstract
Arterial occlusion by thrombosis is the immediate cause of some strokes, heart attacks, and peripheral artery disease. Most prior studies assume that coagulation creates the thrombus. However, a contradiction arises as whole blood (WB) clots from coagulation are too weak to stop arterial blood pressures (> 150 mmHg). We measure the material mechanical properties of elasticity and ultimate strength for Shear-Induced Platelet Aggregation (SIPA) type clots, that form under stenotic arterial hemodynamics in comparison with coagulation clots. The ultimate strength of SIPA clots averaged 4.6 ± 1.3 kPa, while WB coagulation clots had a strength of 0.63 ± 0.3 kPa (p < 0.05). The elastic modulus of SIPA clots was 3.8 ± 1.5 kPa at 1 Hz and 0.5 mm displacement, or 2.8 times higher than WB coagulation clots (1.3 ± 1.2 kPa, p < 0.0001). This study shows that the SIPA thrombi, formed quickly under high shear hemodynamics, is seven-fold stronger and three-fold stiffer compared to WB coagulation clots. A force balance calculation shows a SIPA clot has the strength to resist arterial pressure with a short length of less than 2 mm, consistent with coronary pathology.
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Affiliation(s)
- Dongjune A Kim
- Georgia Institute of Technology, G.W. Woodruff School of Mechanical Engineering, 315 Ferst Drive NW, IBB 2307, Atlanta, GA, 30332, USA
| | - David N Ku
- Georgia Institute of Technology, G.W. Woodruff School of Mechanical Engineering, 315 Ferst Drive NW, IBB 2307, Atlanta, GA, 30332, USA.
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2
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Talebibarmi P, Vahidi B, Ebad M. In silico analysis of embolism in cerebral arteries using fluid-structure interaction method. Heliyon 2024; 10:e30443. [PMID: 38720729 PMCID: PMC11077041 DOI: 10.1016/j.heliyon.2024.e30443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
Ischemic stroke, particularly embolic stroke, stands as a significant global contributor to mortality and long-term disabilities. This paper presents a comprehensive simulation of emboli motion through the middle cerebral artery (MCA), a prevalent site for embolic stroke. Our patient-specific computational model integrates major branches of the middle cerebral artery reconstructed from magnetic resonance angiography images, pulsatile flow dynamics, and emboli of varying geometries, sizes, and material properties. The fluid-structure interactions method is employed to simulate deformable emboli motion through the middle cerebral artery, allowing observation of hemodynamic changes in artery branches upon embolus entry. We investigated the impact of embolus presence on shear stress magnitude on artery walls, analyzed the effects of embolus material properties and geometries on embolus trajectory and motion dynamics within the middle cerebral artery. Additionally, we evaluated the non-Newtonian behavior of blood, comparing it with Newtonian blood behavior. Our findings highlight that embolus geometry significantly influences trajectory, motion patterns, and hemodynamics within middle cerebral artery branches. Emboli with visco-hyperelastic material properties experienced higher stresses upon collision with artery walls compared to those with hyperelastic properties. Furthermore, considering blood as a non-Newtonian fluid had notable effects on emboli stresses and trajectories within the artery, particularly during collisions. Notably, the maximum von Mises stress experienced in our study was 21.83 kPa, suggesting a very low probability of emboli breaking during movement, impact, and after coming to a stop. However, in certain situations, the magnitude of shear stress on them exceeded 1 kPa, increasing the likelihood of cracking and disintegration. These results serve as an initial step in anticipating critical clinical conditions arising from arterial embolism in the middle cerebral artery. They provide insights into the biomechanical parameters influencing embolism, contributing to improved clinical decision-making for stroke management.
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Affiliation(s)
- Pouria Talebibarmi
- Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - Bahman Vahidi
- Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - Mahtab Ebad
- Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
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3
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Chen X, Li X, Turco S, van Sloun RJG, Mischi M. Ultrasound Viscoelastography by Acoustic Radiation Force: A State-of-the-Art Review. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2024; 71:536-557. [PMID: 38526897 DOI: 10.1109/tuffc.2024.3381529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Ultrasound elastography (USE) is a promising tool for tissue characterization as several diseases result in alterations of tissue structure and composition, which manifest as changes in tissue mechanical properties. By imaging the tissue response to an applied mechanical excitation, USE mimics the manual palpation performed by clinicians to sense the tissue elasticity for diagnostic purposes. Next to elasticity, viscosity has recently been investigated as an additional, relevant, diagnostic biomarker. Moreover, since biological tissues are inherently viscoelastic, accounting for viscosity in the tissue characterization process enhances the accuracy of the elasticity estimation. Recently, methods exploiting different acquisition and processing techniques have been proposed to perform ultrasound viscoelastography. After introducing the physics describing viscoelasticity, a comprehensive overview of the currently available USE acquisition techniques is provided, followed by a structured review of the existing viscoelasticity estimators classified according to the employed processing technique. These estimators are further reviewed from a clinical usage perspective, and current outstanding challenges are discussed.
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Bosio G, Destrempes F, Yazdani L, Roy Cardinal MH, Cloutier G. Resonance, Velocity, Dispersion, and Attenuation of Ultrasound-Induced Shear Wave Propagation in Blood Clot In Vitro Models. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:535-551. [PMID: 38108551 DOI: 10.1002/jum.16387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Improve the characterization of mechanical properties of blood clots. Parameters derived from shear wave (SW) velocity and SW amplitude spectra were determined for gel phantoms and in vitro blood clots. METHODS Homogeneous phantoms and phantoms with gel or blood clot inclusions of different diameters and mechanical properties were analyzed. SW amplitude spectra were used to observe resonant peaks. Parameters derived from those resonant peaks were related to mimicked blood clot properties. Three regions of interest were tested to analyze where resonances occurred the most. For blood experiments, 20 samples from different pigs were analyzed over time during a 110-minute coagulation period using the Young modulus, SW frequency dispersion, and SW attenuation. RESULTS The mechanical resonance was manifested by an increase in the number of SW spectral peaks as the inclusion diameter was reduced (P < .001). In blood clot inclusions, the Young modulus increased over time during coagulation (P < .001). Descriptive spectral parameters (frequency peak, bandwidth, and distance between resonant peaks) were linearly correlated with clot elasticity values (P < .001) with R2 = .77 for the frequency peak, .60 for the bandwidth, and .48 for the distance between peaks. The SW dispersion and SW attenuation reflecting the viscous behavior of blood clots decreased over time (P < .001), mainly in the early stage of coagulation (first minutes). CONCLUSION The confined soft inclusion configuration favored SW mechanical resonances potentially challenging the computation of spectral-based parameters, such as the SW attenuation. The impact of resonances can be reduced by properly selecting the region of interest for data analysis.
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Affiliation(s)
- Guillaume Bosio
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Ladan Yazdani
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Marie-Hélène Roy Cardinal
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Guy Cloutier
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, Quebec, Canada
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5
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Wu H, Tang Y, Zhang B, Klippel P, Jing Y, Yao J, Jiang X. Miniaturized Stacked Transducer for Intravascular Sonothrombolysis With Internal-Illumination Photoacoustic Imaging Guidance and Clot Characterization. IEEE Trans Biomed Eng 2023; 70:2279-2288. [PMID: 37022249 PMCID: PMC10399617 DOI: 10.1109/tbme.2023.3240725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Thromboembolism in blood vessels can lead to stroke or heart attack and even sudden death unless brought under control. Sonothrombolysis enhanced by ultrasound contrast agents has shown promising outcome on effective treatment of thromboembolism. Intravascular sonothrombolysis was also reported recently with a potential for effective and safe treatment of deep thrombosis. Despite the promising treatment results, the treatment efficiency for clinical application may not be optimized due to the lack of imaging guidance and clot characterization during the thrombolysis procedure. In this paper, a miniaturized transducer was designed to have an 8-layer PZT-5A stacked with an aperture size of 1.4 × 1.4 mm2 and assembled in a customized two-lumen 10-Fr catheter for intravascular sonothrombolysis. The treatment process was monitored with internal-illumination photoacoustic tomography (II-PAT), a hybrid imaging modality that combines the rich contrast of optical absorption and the deep penetration of ultrasound detection. With intravascular light delivery using a thin optical fiber integrated with the intravascular catheter, II-PAT overcomes the penetration depth limited by strong optical attenuation of tissue. In-vitro PAT-guided sonothrombolysis experiments were carried out with synthetic blood clots embedded in tissue phantom. Clot position, shape, stiffness, and oxygenation level can be estimated by II-PAT at clinically relevant depth of ten centimeters. Our findings have demonstrated the feasibility of the proposed PAT-guided intravascular sonothrombolysis with real-time feedback during the treatment process.
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Bader KB, Flores Basterrechea K, Hendley SA. In silico assessment of histotripsy-induced changes in catheter-directed thrombolytic delivery. Front Physiol 2023; 14:1225804. [PMID: 37449013 PMCID: PMC10336328 DOI: 10.3389/fphys.2023.1225804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction: For venous thrombosis patients, catheter-directed thrombolytic therapy is the standard-of-care to recanalize the occluded vessel. Limitations with thrombolytic drugs make the development of adjuvant treatments an active area of research. One potential adjuvant is histotripsy, a focused ultrasound therapy that lyses red blood cells within thrombus via the spontaneous generation of bubbles. Histotripsy has also been shown to improve the efficacy of thrombolytic drugs, though the precise mechanism of enhancement has not been elucidated. In this study, in silico calculations were performed to determine the contribution of histotripsy-induced changes in thrombus diffusivity to alter catheter-directed therapy. Methods: An established and validated Monte Carlo calculation was used to predict the extent of histotripsy bubble activity. The distribution of thrombolytic drug was computed with a finite-difference time domain (FDTD) solution of the perfusion-diffusion equation. The FDTD calculation included changes in thrombus diffusivity based on outcomes of the Monte Carlo calculation. Fibrin degradation was determined using the known reaction rate of thrombolytic drug. Results: In the absence of histotripsy, thrombolytic delivery was restricted in close proximity to the catheter. Thrombolytic perfused throughout the focal region for calculations that included the effects of histotripsy, resulting in an increased degree of fibrinolysis. Discussion: These results were consistent with the outcomes of in vitro studies, suggesting histotripsy-induced changes in the thrombus diffusivity are a primary mechanism for enhancement of thrombolytic drugs.
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Affiliation(s)
- Kenneth B. Bader
- Department of Radiology, University of Chicago, Chicago, IL, United States
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7
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Tan ZQ, Ooi EH, Chiew YS, Foo JJ, Ng EYK, Ooi ET. A computational framework for the multiphysics simulation of microbubble-mediated sonothrombolysis using a forward-viewing intravascular transducer. ULTRASONICS 2023; 131:106961. [PMID: 36812819 DOI: 10.1016/j.ultras.2023.106961] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/08/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Sonothrombolysis is a technique that utilises ultrasound waves to excite microbubbles surrounding a clot. Clot lysis is achieved through mechanical damage induced by acoustic cavitation and through local clot displacement induced by acoustic radiation force (ARF). Despite the potential of microbubble-mediated sonothrombolysis, the selection of the optimal ultrasound and microbubble parameters remains a challenge. Existing experimental studies are not able to provide a complete picture of how ultrasound and microbubble characteristics influence the outcome of sonothrombolysis. Likewise, computational studies have not been applied in detail in the context of sonothrombolysis. Hence, the effect of interaction between the bubble dynamics and acoustic propagation on the acoustic streaming and clot deformation remains unclear. In the present study, we report for the first time the computational framework that couples the bubble dynamic phenomena with the acoustic propagation in a bubbly medium to simulate microbubble-mediated sonothrombolysis using a forward-viewing transducer. The computational framework was used to investigate the effects of ultrasound properties (pressure and frequency) and microbubble characteristics (radius and concentration) on the outcome of sonothrombolysis. Four major findings were obtained from the simulation results: (i) ultrasound pressure plays the most dominant role over all the other parameters in affecting the bubble dynamics, acoustic attenuation, ARF, acoustic streaming, and clot displacement, (ii) smaller microbubbles could contribute to a more violent oscillation and improve the ARF simultaneously when they are stimulated at higher ultrasound pressure, (iii) higher microbubbles concentration increases the ARF, and (iv) the effect of ultrasound frequency on acoustic attenuation is dependent on the ultrasound pressure. These results may provide fundamental insight that is crucial in bringing sonothrombolysis closer to clinical implementation.
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Affiliation(s)
- Zhi Q Tan
- Mechanical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ean H Ooi
- Mechanical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia.
| | - Yeong S Chiew
- Mechanical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ji J Foo
- Mechanical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Eddie Y K Ng
- School of Mechanical and Aerospace Engineering, College of Engineering, Nanyang Technological University, 50 Nanyang Avenue 639798, Singapore
| | - Ean T Ooi
- School of Engineering and Information Technology, Faculty of Science and Technology, Federation University, VIC 3350, Australia
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8
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Mirakhorli F, Vahidi B, Pazouki M, Barmi PT. A Fluid-Structure Interaction Analysis of Blood Clot Motion in a Branch of Pulmonary Arteries. Cardiovasc Eng Technol 2023; 14:79-91. [PMID: 35788909 DOI: 10.1007/s13239-022-00632-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Pulmonary embolism (PE) is one of the most prevalent diseases amid hospitalized patients taking many people's lives annually. This phenomenon, however, has not been investigated via numerical simulations. METHODS In this study, an image-based model of pulmonary arteries has been constructed from a 44-year-old man's computed tomography images. The fluid-structure interaction method was used to simulate the motion of the blood clot. In this regard, Navier-Stokes equations, as the governing equations, have been solved in an arbitrary Lagrangian-Eulerian (ALE) formulation. RESULTS According to our results, the velocity of visco-hyperelastic model of the emboli was relatively higher than the emboli with hyperelastic model, despite their similar behavioral pattern. The stresses on the clot were also investigated and showed that the blood clot continuously sustained stresses greater than 165 Pa over an about 0.01 s period, which can cause platelets to leak and make the clot grow or tear apart. CONCLUSIONS It could be concluded that in silico analysis of the cardiovascular diseases initiated from clot motion in blood flow is a valuable tool for a better understanding of these phenomena.
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Affiliation(s)
- Fateme Mirakhorli
- Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - Bahman Vahidi
- Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran.
| | - Marzieh Pazouki
- Department of Pulmonary Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pouria Talebi Barmi
- Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
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9
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Bosio G, Zenati N, Destrempes F, Chayer B, Pernod G, Cloutier G. Shear Wave Elastography and Quantitative Ultrasound as Biomarkers to Characterize Deep Vein Thrombosis In Vivo. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1807-1816. [PMID: 34713918 DOI: 10.1002/jum.15863] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Investigate shear wave elastography (SWE) and quantitative ultrasound (QUS) parameters in patients hospitalized for lower limb deep vein thrombosis (DVT). METHOD Sixteen patients with DVT were recruited and underwent SWE and radiofrequency data acquisitions for QUS on day 0, day 7, and day 30 after the beginning of symptoms, in both proximal and distal zones of the clot identified on B-mode scan. SWE and QUS features were computed to differentiate between thrombi at day 0, day 7, and day 30 following treatment with heparin or oral anticoagulant. The Young's modulus from SWE was computed, as well as QUS homodyned K-distribution (HKD) parameters reflecting blood clot structure. Median and interquartile range of SWE and QUS parameters within clot were taken as features. RESULTS In the proximal zone of the clot, the HKD ratio of coherent-to-diffuse backscatter median showed a significant decrease from day 7 to day 30 (P = .036), while the HKD ratio of diffuse-to-total backscatter median presented a significant increase from day 7 to day 30 (P = .0491). In the distal zone of the clot, the HKD normalized intensity of the echo envelope median showed a significant increase from day 0 to day 30 (P = .0062). No SWE features showed statistically significant differences over time. Nonetheless, a trend of lower median of Young's modulus within clot for patients who developed a pulmonary embolism was observed. CONCLUSION QUS features may be relevant to characterize clot's evolution over time. Further analysis of their clinical interpretation and validation on a larger dataset would deserve to be studied.
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Affiliation(s)
- Guillaume Bosio
- Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada
| | - Nora Zenati
- UGA UFRM-Université Grenoble Alpes-UFR Médecine, Grenoble, France
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada
| | - Boris Chayer
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada
| | - Gilles Pernod
- UGA UFRM-Université Grenoble Alpes-UFR Médecine, Grenoble, France
- Centre Hospitalier Universitaire de Grenoble, Grenoble, France
- F-CRIN INNOVTE Network, Saint Etienne, France
| | - Guy Cloutier
- Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montréal, Québec, Canada
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10
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Guzman-Sepulveda JR, Batarseh M, Wu R, DeCampli WM, Dogariu A. Passive high-frequency microrheology of blood. SOFT MATTER 2022; 18:2452-2461. [PMID: 35279707 PMCID: PMC8941587 DOI: 10.1039/d1sm01726h] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Indicative of various pathologies, blood properties are under intense scrutiny. The hemorheological characteristics are traditionally gauged by bulk, low-frequency indicators that average out critical information about the complex, multi-scale, and multi-component structure. In particular, one cannot discriminate between the erythrocytes contribution to global rheology and the impact of plasma. Nevertheless, in their fast stochastic movement, before they encounter each other, the erythrocytes probe the subtle viscoelasticity of their protein-rich environment. Thus, if these short time scales can be resolved experimentally, the plasma properties could be determined without having to separate the blood components; the blood is practically testing itself. This microrheological description of blood plasma provides a direct link between the composition of whole blood and its coagulability status. We present a parametric model for the viscoelasticity of plasma, which is probed by the erythrocytes over frequency ranges of kilohertz in a picoliter-sized volume. The model is validated both in vitro, using artificial hemo-systems where the composition is controlled, as well as on whole blood where continuous measurements provide real-time information. We also discuss the possibility of using this passive microrheology as an in vivo assay for clinically relevant situations where the blood clotting condition must be observed and managed continuously for diagnosis or during therapeutic procedures at different stages of hemostatic and thrombotic processes.
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Affiliation(s)
- Jose Rafael Guzman-Sepulveda
- CREOL, The College of Optics and Photonics, University of Central Florida, 4304 Scorpius, Orlando, Florida, 32816, USA.
| | - Mahed Batarseh
- CREOL, The College of Optics and Photonics, University of Central Florida, 4304 Scorpius, Orlando, Florida, 32816, USA.
| | - Ruitao Wu
- CREOL, The College of Optics and Photonics, University of Central Florida, 4304 Scorpius, Orlando, Florida, 32816, USA.
| | - William M DeCampli
- Pediatric Cardiothoracic Surgery, The Heart Center, Arnold Palmer Hospital for Children, Orlando, Florida, USA
- College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Aristide Dogariu
- CREOL, The College of Optics and Photonics, University of Central Florida, 4304 Scorpius, Orlando, Florida, 32816, USA.
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11
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Khan Z, Ul Haq S, Ali F, Andualem M. Free convection flow of second grade dusty fluid between two parallel plates using Fick's and Fourier's laws: a fractional model. Sci Rep 2022; 12:3448. [PMID: 35236870 PMCID: PMC8891311 DOI: 10.1038/s41598-022-06153-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/17/2022] [Indexed: 11/09/2022] Open
Abstract
The paper aims to investigate the channel flow of second grade visco-elastic fluid generated due to an oscillating wall. The effect of heat and mass transfer has been taken into account. The phenomenon has been modelled in terms of PDEs. The constitutive equations are fractionalized by using the definition of the Caputo fractional operator with Fick’s and Fourier’s Laws. The system of fractional PDEs is non-dimensionalized by using appropriate dimensionless variables. The closed-form solutions of thermal and concentration boundary layers are obtained by using the Laplace and finite Fourier-Sine transforms, while the momentum equation is solved by a numerical approach by Zakian using \documentclass[12pt]{minimal}
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\begin{document}$$\textit{PYTHON}$$\end{document}PYTHON. Furthermore, the parametric influence of various embedded physical parameters on momentum, temperature, and concentration distributions is depicted through various graphs. It is observed that the fractional approach is more convenient and realistic as compared to the classical approach. It is worth noting that the increasing values of \documentclass[12pt]{minimal}
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\begin{document}$$Re$$\end{document}Re retard the boundary layer profile. For instance, this behaviour of \documentclass[12pt]{minimal}
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\begin{document}$$M$$\end{document}M is significant where boundary control is necessary. That is, in the case of resonance, the physical solution may be obtained by adding the effect of MHD. The Reynolds number is useful in characterising the transport properties of a fluid or a particle travelling through a fluid. The Reynolds number is one of the main controlling parameters in all viscous flow. It determines whether the fluid flow is laminar or turbulent. The evolution of the rate of heat, mass transfer, and skin friction on the left plate with various physical parameters are presented in tables. These quantities are of high interest for engineers. Keeping in mind the effect of various parameters on these engineering quantities, they make their feasibility reports.
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Affiliation(s)
- Zahid Khan
- Department of Mathematics, Islamia College Peshawar, Peshawar, 25000, Khyber PakhtunKhwa, Pakistan
| | - Sami Ul Haq
- Department of Mathematics, Islamia College Peshawar, Peshawar, 25000, Khyber PakhtunKhwa, Pakistan
| | - Farhad Ali
- Department of Mathematics, City University of Science & Information Technology, Peshawar, 25000, Pakistan.
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12
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Costa-Júnior JFS, Parcero GC, Machado JC. Shear Elastic Coefficient of Normal and Fibrinogen-Deficient Clotting Plasma Obtained with a Sphere-Motion-Based Acoustic-Radiation-Force Approach. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:111-123. [PMID: 34674885 DOI: 10.1016/j.ultrasmedbio.2021.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
Blood coagulation is a process involving several chemical reactions governed by coagulation factors, during which the shear elastic coefficient, μ, varies as the medium transitions from liquid to gel phase. This work used ultrasound to measure μ during the clotting of human plasma samples by tracking the motion of a glass sphere located inside a cuvette filled with the plasma. A 2.03 MHz ultrasonic system generated an impulsive acoustic radiation force acting on the sphere, and a 4.89 MHz pulse-echo ultrasonic system tracked the sphere displacement induced by that force. Measurements of μ were determined by fitting a μ-dependent theoretical model to the motion waveform of the sphere immersed in clotting normal plasma and plasma samples with fibrinogen (FI) concentrations of 1.2 (FI-deficiency) and 3.6 (FI-normal) g/L. For normal plasma, μ started at 14.22 Pa and increased rapidly until 2 min, then slowly until it reached 210.23 Pa at 35 min after the clotting process started. A similar trend was exhibited in plasma samples with FI concentrations of 1.2 and 3.6 g/L, with μ reaching 120.55 and 679.42 Pa, respectively. A theoretical model, related to the kinetics of clot-structure formation, describes the time changes of μ for the clotting plasma samples. The sphere-motion-based acoustic-radiation-force approach allowed us to measure the shear elastic coefficient during the coagulation process of plasma samples with normal and deficient FI concentrations. Our results suggest that the method used in this study is capable of being used to detect bleeding disorders.
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Affiliation(s)
- José Francisco Silva Costa-Júnior
- Brazilian Air Force Academy, Pirassununga, Brazil; Biomedical Engineering Program-COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | - João Carlos Machado
- Biomedical Engineering Program-COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Post-Graduation Program on Surgical Sciences, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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13
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Tashiro K, Shobayashi Y, Ota I, Hotta A. Finite element analysis of blood clots based on the nonlinear visco-hyperelastic model. Biophys J 2021; 120:4547-4556. [PMID: 34478700 DOI: 10.1016/j.bpj.2021.08.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/25/2021] [Accepted: 08/26/2021] [Indexed: 11/18/2022] Open
Abstract
Mechanical thrombectomy has become the standard treatment for patients with an acute ischemic stroke. In this approach, to remove blood clots, mechanical force is applied using thrombectomy devices, in which the interaction between the clot and the device could significantly affect the clot retrieval performance. It is expected that the finite element method (FEM) could visualize the mechanical interaction by the visualization of the stress transmission from the device to the clot. This research was aimed at verifying the constitutive theory by implementing FEM based on the visco-hyperelastic theory, using a three-dimensional clot model. We used the visco-hyperelastic FEM to reproduce the mechanical behavior of blood clots, as observed in experiments. This study is focused on the mechanical responses of clots under tensile loading and unloading because in mechanical thrombectomy, elongation is assumed to occur locally on the clots during the retrieval process. Several types of cylindrical clots were created by changing the fibrinogen dose. Tensile testing revealed that the stiffness (E0.45-value) of clots with fibrinogen could be more than three times higher than that of clots without fibrinogen. It was also found that the stiffness was not proportional to the fibrinogen dose. By fitting to the theoretical curve, it was revealed that the Mooney-Rivlin model could reproduce the hyperelastic characteristics of clots well. From the stress-relaxation data, the three-chain Maxwell model could accurately fit the experimental viscoelastic data. FEM, taking the theoretical models into account, was then carried out, and the results matched well with the experimental visco-hyperelastic characteristics of clots under tensile load, reproducing the mechanical hysteresis during unloading, the stress dependence on the strain rate, and the time-dependent stress decrease in the stress-relaxation test.
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Affiliation(s)
- Koichiro Tashiro
- Department of Mechanical Engineering, Keio University, Kohoku-ku, Yokohama, Japan; Biomedical Solutions Inc., Chuo-ku, Tokyo, Japan
| | | | - Iku Ota
- Department of Mechanical Engineering, Keio University, Kohoku-ku, Yokohama, Japan
| | - Atsushi Hotta
- Department of Mechanical Engineering, Keio University, Kohoku-ku, Yokohama, Japan.
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14
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Costa-Júnior JFS, Machado JC. Dynamic assessment of plasma clotting in samples with distinct fibrinogen concentrations using impulsive acoustic radiation force. ULTRASONICS 2021; 116:106515. [PMID: 34252874 DOI: 10.1016/j.ultras.2021.106515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/12/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
While some diseases reduce fibrinogen concentration, others increase the amount of this clotting factor in the blood. Some studies have shown that the fibrinogen concentration in the blood is related to the stiffness of the formed clot. Hence, the aim of this study was to employ an ultrasonic method based on impulsive acoustic radiation force (IARF) to identify the fibrinogen concentration (coagulation factor I) in a plasma sample by means of peak-displacement (PD), time of peak-displacement (TPD), and shear modulus (μ) as well as to identify the change of plasma samples during the clot formation process. The IARF-based ultrasonic system transmitted bursts with a frequency of 2.03 MHz, duration of 246.31 µs, amplitude of 118 VPP, and pulse with 1.25 Hz repetition frequency to generate an IARF on a glass sphere (2.99 mm in diameter and 2500 kg/m3 in density) embedded in a plasma sample, causing a displacement that was monitored by a pulse-echo system with a center frequency of 4.89 MHz. The values of the shear moduli were 124.14 ± 3.02, 556.99 ± 11.76, and 670.39 ± 9.77 Pa, for fibrinogen concentrations of 1.2, 2.4, and 3.6 g/L 20 to 36 min after the beginning of the coagulation process. The TPD values obtained in the same period were 5.28 ± 0.09, 3.03 ± 0.02, and 2.83 ± 0.01 s. The results indicate that an IARF-based ultrasonic system can be used clinically because it uses small amounts of plasma and has the ability to detect differences in PD, TPD, and μ as a function of fibrinogen concentrations.
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Affiliation(s)
- José Francisco Silva Costa-Júnior
- Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Brazilian Air Force Academy, Pirassununga, SP, Brazil.
| | - João Carlos Machado
- Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Post-Graduation Program on Surgical Sciences-School of Medicine/Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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15
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Du J, Aspray E, Fogelson A. Computational investigation of platelet thrombus mechanics and stability in stenotic channels. J Biomech 2021; 122:110398. [PMID: 33933859 DOI: 10.1016/j.jbiomech.2021.110398] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
The stability of a platelet thrombus under flow is believed to depend strongly on the local hemodynamics and on the thrombus' porosity, permeability, and elasticity. A two-phase continuum model is used to investigate the biomechanics of thrombus stability in stenotic channels. It treats the thrombus as a porous, viscoelastic material moving differently than the background fluid. The dynamic clot-flow interaction is modeled through a frictional drag term. The model explicitly tracks the formation and breaking of interplatelet molecular bonds, which directly determine the viscoelastic property of the thrombus and govern its ability to resist fluid drag. We characterize the stability/fragility of thrombi for various flow speeds, porosities, bond concentrations, and bond types.
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Affiliation(s)
- Jian Du
- Department of Mathematical Sciences, Florida Institute of Technology, Melbourne, FL 32940, United States
| | - Elise Aspray
- Department of Mathematical Sciences, Florida Institute of Technology, Melbourne, FL 32940, United States
| | - Aaron Fogelson
- Departments of Mathematics and Biomedical Engineering, University of Utah, Salt Lake City, UT 84102, United States.
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16
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Seki H, Fujiwara T, Hijikata W, Murashige T, Tahara T, Yokota S, Ogata A, Ohuchi K, Mizuno T, Arai H. Evaluation of real-time thrombus detection method in a magnetically levitated centrifugal blood pump using a porcine left ventricular assist circulation model. Artif Organs 2021; 45:726-735. [PMID: 33432615 DOI: 10.1111/aor.13915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 01/08/2023]
Abstract
Pump thrombosis induces significant complications and requires timely detection. We proposed real-time monitoring of pump thrombus in a magnetically levitated centrifugal blood pump (mag-lev pump) without using additional sensors, by focusing on the changes in the displacement of the pump impeller. The phase difference between the current and displacement of the impeller increases with pump thrombus. This thrombus detection method was previously evaluated through simulated circuit experiments using porcine blood. Evaluation of real-time thrombus detection in a mag-lev blood pump was performed using a porcine left ventricular assist circulation model in this study. Acute animal experiments were performed five times using five Japanese domestic pigs. To create thrombogenic conditions, fibrinogen coating that induces thrombus formation in a short time was applied to the inner surfaces of the pump. An inflow and an outflow cannula were inserted into the apex of the left ventricle and the carotid artery, respectively, by a minimally invasive surgical procedure that allowed minimal bleeding and hypothermia. Pump flow was maintained at 1 L/min without anticoagulation. The vibrational frequency of the impeller (70 Hz) and its vibrational amplitude (30 μm) were kept constant. The thrombus was detected based on the fact that the phase difference between the impeller displacement and input current to the magnetic bearing increases when a thrombus is formed inside a pump. The experiment was terminated when the phase difference increased by over 1° from the lowest value or when the phase difference was at the lowest value 12 hours after commencing measurements. The phase difference increased by over 1° in three cases. The pump was stopped after 12 hours in two cases. Pump thrombi were found in the pump in three cases in which the phase difference increased by over 1°. No pump thrombus was found in the other two cases in which the phase difference did not increase. We succeeded in real-time thrombus monitoring of a mag-lev pump in acute animal experiments.
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Affiliation(s)
- Haruna Seki
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Hijikata
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Tomotaka Murashige
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan.,Department of Advanced Surgical Technology Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoki Tahara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sachie Yokota
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Asato Ogata
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsuhiro Ohuchi
- Department of Advanced Surgical Technology Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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17
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Liu HC, Abbasi M, Ding YH, Roy T, Capriotti M, Liu Y, Fitzgerald S, Doyle KM, Guddati M, Urban MW, Brinjikji W. Characterizing blood clots using acoustic radiation force optical coherence elastography and ultrasound shear wave elastography. Phys Med Biol 2021; 66:035013. [PMID: 33202384 PMCID: PMC7880883 DOI: 10.1088/1361-6560/abcb1e] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Thromboembolism in a cerebral blood vessel is associated with high morbidity and mortality. Mechanical thrombectomy (MT) is one of the emergenc proceduresperformed to remove emboli. However, the interventional approaches such as aspiration catheters or stent retriever are empirically selected. An inappropriate selection of surgical devices can influence the success rate during embolectomy, which can lead to an increase in brain damage. There has been growing interest in the study of clot composition and using a priori knowledge of clot composition to provide guidance for an appropriate treatment strategy for interventional physicians. Developing imaging tools which can allow interventionalists to understand clot composition could affect management and device strategy. In this study, we investigated how clots of different compositions can be characterized by using acoustic radiation force optical coherence elastography (ARF-OCE) and compared with ultrasound shear wave elastography (SWE). Five different clots compositions using human blood were fabricated into cylindrical forms from fibrin-rich (21% red blood cells, RBCs) to RBC-rich (95% RBCs). Using the ARF-OCE and SWE, we characterized the wave velocities measured in the time-domain. In addition, the semi-analytical finite element model was used to explore the relationship between the phase velocities with various frequency ranges and diameters of the clots. The study demonstrated that the wave group velocities generally decrease as RBC content increases in ARF-OCE and SWE. The correlation of the group velocities from the OCE and SWE methods represented a good agreement as RBC composition is larger than 39%. Using the phase velocity dispersion analysis applied to ARF-OCE data, we estimated the shear wave velocities decoupling the effects of the geometry and material properties of the clots. The study demonstrated that the composition of the clots can be characterized by elastographic methods using ARF-OCE and SWE, and OCE demonstrated better ability to discriminate between clots of different RBC compositions, compared to the ultrasound-based approach, especially in clots with low RBC compositions.
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Affiliation(s)
- Hsiao-Chuan Liu
- Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
- Author to whom any correspondence should be addressed
| | - Mehdi Abbasi
- Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
| | - Yong Hong Ding
- Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
| | - Tuhin Roy
- Department of Civil Engineering, North Carolina State University, Raleigh, NC 27695, United States of America
| | - Margherita Capriotti
- Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
| | - Yang Liu
- Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
| | - Seán Fitzgerald
- Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
- Department of Physiology, National University of Ireland Galway, Galway, Ireland
| | - Karen M Doyle
- Department of Physiology, National University of Ireland Galway, Galway, Ireland
| | - Murthy Guddati
- Department of Civil Engineering, North Carolina State University, Raleigh, NC 27695, United States of America
| | - Matthew W Urban
- Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic in Rochester, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
| | - Waleed Brinjikji
- Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America
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18
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Malone F, McCarthy E, Delassus P, Buhk JH, Fiehler J, Morris L. An in vitro assessment of atrial fibrillation flow types on cardiogenic emboli trajectory paths. Proc Inst Mech Eng H 2020; 234:1421-1431. [DOI: 10.1177/0954411920946873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Atrial fibrillation is the most significant contributor to thrombus formation within the heart and is responsible for 45% of all cardio embolic strokes, which account for approximately 15% of acute ischemic strokes cases worldwide. Atrial fibrillation can result in a reduction of normal cardiac output and cycle length of up to 30% and 40%, respectively. A total of 240 embolus analogues were released into a thin-walled, patient-specific aortic arch under normal (60 embolus analogues) and varying atrial fibrillation (180 embolus analogues) pulsatile flow conditions. Under healthy flow conditions (n = 60), the embolus analogues tended to follow the flow rate split through each outlet vessel. There was an increase in clot trajectories along the common carotid arteries under atrial fibrillation flow conditions. A shorter pulse period (0.3 s) displayed the highest percentage of clots travelling to the brain (24%), with a greater percentage of clots travelling through the left common carotid artery (17%). This study provides an experimental insight into the effect varying cardiac output and cycle length can have on the trajectory of a cardiac source blood clots travelling to the cerebral vasculature and possibly causing a stroke.
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Affiliation(s)
- Fiona Malone
- GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland
| | - Eugene McCarthy
- GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland
| | - Patrick Delassus
- GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland
| | - Jan-Hendrick Buhk
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Liam Morris
- GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland
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19
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Liu Y, Reddy AS, Cockrum J, Ajulufoh MC, Zheng Y, Shih AJ, Pandey AS, Savastano LE. Standardized Fabrication Method of Human-Derived Emboli with Histologic and Mechanical Quantification for Stroke Research. J Stroke Cerebrovasc Dis 2020; 29:105205. [PMID: 33066901 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105205] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/01/2020] [Accepted: 07/23/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND As access to patient emboli is limited, embolus analogs (EAs) have become critical to the research of large vessel occlusion (LVO) stroke and the development of thrombectomy technology. To date, techniques for fabricating standardized human blood-derived EAs are limited in the variety of compositions, and the mechanical properties relevant to thrombectomy are not quantified. METHODS EAs were made by mixing human banked red blood cells (RBCs), plasma, and platelet concentrate in 10 different volumetric percentage combinations to mimic the broad range of patient emboli causing LVO strokes. The samples underwent histologic analysis and tensile testing to mimic the pulling action of thrombectomy devices, and were compared to patient emboli. RESULTS EAs had histologic compositions of 0-96% RBCs, 0.78%-92% fibrin, and 2.1%-22% platelets, which can be correlated with the ingredients using a regression model. At fracture, EAs elongated from 81% to 136%, and the ultimate tensile stress ranged from 16 to 949 kPa. These EAs' histologic compositions and tensile properties showed great similarity to those of emboli retrieved from LVO stroke patients, indicating the validity of such EA fabrication methods. EAs with lower RBC and higher fibrin contents are more extensible and can withstand higher tensile stress. CONCLUSIONS EAs fabricated and tested using the proposed new methods provide a platform for stroke research and pre-clinical development of thrombectomy devices.
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Affiliation(s)
- Yang Liu
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA.
| | - Adithya S Reddy
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
| | - Joshua Cockrum
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
| | | | - Yihao Zheng
- Mechanical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA.
| | - Albert J Shih
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA.
| | - Aditya S Pandey
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
| | - Luis E Savastano
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA; Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
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20
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Investigating the Mechanical Behavior of Clot Analogues Through Experimental and Computational Analysis. Ann Biomed Eng 2020; 49:420-431. [PMID: 32691265 DOI: 10.1007/s10439-020-02570-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022]
Abstract
With mechanical thrombectomy emerging as the new standard of care for stroke treatment, clot analogues provide an extremely useful tool in the testing and design of these treatment devices. The aim of this study is to characterise the mechanical behavior of thrombus analogues as a function of composition. Platelet-contracted clot analogues were prepared from blood mixtures of various hematocrits. Mechanical testing was performed whereby clots were subjected to unconfined compression between two rigid plates. Two loading protocols were imposed: cyclic compression for 10 cycles at a constant strain-rate magnitude; stress-relaxation at a constant applied compressive strain. A hyper-viscoelastic constitutive law was identified and calibrated based on the experimental mechanical test data. Scanning electron microscopy (SEM) investigated the clot microstructure at various time-points. Clot analogue composition was found to strongly affect the observed mechanical behavior. The SEM found that the microstructure of the clot analogues was affected by the storage solution and age of the clot. The proposed hyper-viscoelastic constitutive model was found to successfully capture the material test data. The results presented in this study are of key importance to the evaluation and future development mechanical thrombectomy devices and procedures.
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21
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Borin D, Peña B, Taylor MR, Mestroni L, Lapasin R, Sbaizero O. Viscoelastic behavior of cardiomyocytes carrying LMNA mutations. Biorheology 2020; 57:1-14. [DOI: 10.3233/bir-190229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | - Brisa Peña
- University of Colorado Anschutz Medical Campus - Aurora, CO, , USA
| | | | - Luisa Mestroni
- University of Colorado Anschutz Medical Campus - Aurora, CO, , USA
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22
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Seki H, Fujiwara T, Hijikata W, Murashige T, Maruyama T, Yokota S, Ogata A, Ouchi K, Mizuno T, Arai H. Verification of a thrombus induction method at the target point inside the blood pump using a fibrinogen coating for a thrombus detection study. Artif Organs 2020; 44:968-975. [DOI: 10.1111/aor.13743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Haruna Seki
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Wataru Hijikata
- School of Engineering Tokyo Institute of Technology Tokyo Japan
| | | | - Takuro Maruyama
- School of Engineering Tokyo Institute of Technology Tokyo Japan
| | - Sachie Yokota
- Faculty of Medicine Tokyo Medical and Dental University Tokyo Japan
| | - Asato Ogata
- Faculty of Medicine Tokyo Medical and Dental University Tokyo Japan
| | - Katsuhiro Ouchi
- Department of Advanced Surgical Technology Research and Development Tokyo Medical and Dental University Tokyo Japan
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
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23
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Rus G, Faris IH, Torres J, Callejas A, Melchor J. Why Are Viscosity and Nonlinearity Bound to Make an Impact in Clinical Elastographic Diagnosis? SENSORS (BASEL, SWITZERLAND) 2020; 20:E2379. [PMID: 32331295 PMCID: PMC7219338 DOI: 10.3390/s20082379] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/24/2022]
Abstract
The adoption of multiscale approaches by the biomechanical community has caused a major improvement in quality in the mechanical characterization of soft tissues. The recent developments in elastography techniques are enabling in vivo and non-invasive quantification of tissues' mechanical properties. Elastic changes in a tissue are associated with a broad spectrum of pathologies, which stems from the tissue microstructure, histology and biochemistry. This knowledge is combined with research evidence to provide a powerful diagnostic range of highly prevalent pathologies, from birth and labor disorders (prematurity, induction failures, etc.), to solid tumors (e.g., prostate, cervix, breast, melanoma) and liver fibrosis, just to name a few. This review aims to elucidate the potential of viscous and nonlinear elastic parameters as conceivable diagnostic mechanical biomarkers. First, by providing an insight into the classic role of soft tissue microstructure in linear elasticity; secondly, by understanding how viscosity and nonlinearity could enhance the current diagnosis in elastography; and finally, by compounding preliminary investigations of those elastography parameters within different technologies. In conclusion, evidence of the diagnostic capability of elastic parameters beyond linear stiffness is gaining momentum as a result of the technological and imaging developments in the field of biomechanics.
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Affiliation(s)
- Guillermo Rus
- Ultrasonics Group (TEP-959), Department of Structural Mechanics, University of Granada, 18071 Granada, Spain; (G.R.); (I.H.F.); (A.C.)
- Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
- Excellence Research Unit “ModelingNature” MNat UCE.PP2017.03, University of Granada, 18071 Granada, Spain
| | - Inas H. Faris
- Ultrasonics Group (TEP-959), Department of Structural Mechanics, University of Granada, 18071 Granada, Spain; (G.R.); (I.H.F.); (A.C.)
- Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
| | - Jorge Torres
- Ultrasonics Group (TEP-959), Department of Structural Mechanics, University of Granada, 18071 Granada, Spain; (G.R.); (I.H.F.); (A.C.)
- Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
| | - Antonio Callejas
- Ultrasonics Group (TEP-959), Department of Structural Mechanics, University of Granada, 18071 Granada, Spain; (G.R.); (I.H.F.); (A.C.)
- Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
| | - Juan Melchor
- Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
- Excellence Research Unit “ModelingNature” MNat UCE.PP2017.03, University of Granada, 18071 Granada, Spain
- Department of Statistics and Operations Research, University of Granada, 18071 Granada, Spain
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24
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Hijikata W, Maruyama T, Murashige T, Sakota D, Maruyama O. Detection of thrombosis in a magnetically levitated blood pump by vibrational excitation of the impeller. Artif Organs 2020; 44:594-603. [DOI: 10.1111/aor.13632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/28/2019] [Accepted: 01/03/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Wataru Hijikata
- School of Engineering Tokyo Institute of Technology Tokyo Japan
| | - Takuro Maruyama
- School of Engineering Tokyo Institute of Technology Tokyo Japan
| | | | - Daisuke Sakota
- National Institute of Advanced Industrial Science and Technology Tsukuba Japan
| | - Osamu Maruyama
- National Institute of Advanced Industrial Science and Technology Tsukuba Japan
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25
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Ansari Hosseinzadeh V, Brugnara C, Emani S, Khismatullin D, Holt RG. Monitoring of blood coagulation with non-contact drop oscillation rheometry. J Thromb Haemost 2019; 17:1345-1353. [PMID: 31099102 DOI: 10.1111/jth.14486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/24/2019] [Accepted: 05/01/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Thromboelastography is widely used as a tool to assess the coagulation status of critical-care patients. It allows observation of changes in the material properties of whole blood brought about by clot formation and clot lysis. However, contact activation of the coagulation cascade at surfaces of thromboelastographic systems leads to inherent variability and unreliability in predicting bleeding or thrombosis risks, while also requiring large sample volumes. OBJECTIVES To develop a non-contact drop oscillation rheometry (DOR) method to measure the viscoelastic properties of blood clots and to compare the results with current laboratory standard measurements. METHODS Drops of human blood and plasma (5-10 μL) were acoustically levitated. Acoustic field modulation induced drop shape oscillations, and the viscoelastic properties of the sample were calculated by measuring the resonance frequency and damping ratio. RESULTS DOR showed sensitivity to coagulation parameters. An increase in platelet count resulted in an increase in the maximum clot stiffness. An increase in the calcium ion level enhanced the coagulation rate prior to saturation. An increase in hematocrit resulted in a higher rate of clot formation and increased clot stiffness. Comparison of the results with those obtained with thromboelastography showed that coagulation started sooner with DOR, but with a lower rate and lower maximum stiffness. CONCLUSIONS DOR can be used as a monitoring tool to assess blood coagulation status. The advantages of small sample size, the lack of contact and small strain (linear viscoelasticity) makes this technique unique for real-time monitoring of blood coagulation.
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Affiliation(s)
| | - Carlo Brugnara
- Department of Laboratory Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sirisha Emani
- Department of Laboratory Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Damir Khismatullin
- Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana
| | - R Glynn Holt
- Department of Mechanical Engineering, Boston University, Boston, Massachusetts
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26
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Malone F, McCarthy E, Delassus P, Buhk JH, Fiehler J, Morris L. Investigation of the Hemodynamics Influencing Emboli Trajectories Through a Patient-Specific Aortic Arch Model. Stroke 2019; 50:1531-1538. [DOI: 10.1161/strokeaha.118.023581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Fiona Malone
- From the GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland (F.M., E.M., P.D., L.M.)
| | - Eugene McCarthy
- From the GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland (F.M., E.M., P.D., L.M.)
| | - Patrick Delassus
- From the GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland (F.M., E.M., P.D., L.M.)
| | - Jan-Hendrick Buhk
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Martinistr, Germany (J.-H.B., J.F.)
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Martinistr, Germany (J.-H.B., J.F.)
| | - Liam Morris
- From the GMedTech, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland (F.M., E.M., P.D., L.M.)
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27
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Bhatt M, Moussu MAC, Chayer B, Destrempes F, Gesnik M, Allard L, Tang A, Cloutier G. Reconstruction of Viscosity Maps in Ultrasound Shear Wave Elastography. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:1065-1078. [PMID: 30990181 DOI: 10.1109/tuffc.2019.2908550] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Change in viscoelastic properties of biological tissues may often be symptomatic of a dysfunction that can be correlated to tissue pathology. Shear wave elastography is an imaging method mainly used to assess stiffness but with the potential to measure viscoelasticity of biological tissues. This can enable tissue characterization; and thus, can be used as a marker to improve diagnosis of pathological lesions. In this study, a frequency-shift method based framework is presented for the reconstruction of viscosity by analyzing the spectral properties of acoustic radiation force-induced shear waves. The aim of the study was to investigate the feasibility of viscosity reconstruction maps in homogeneous as well as heterogeneous samples. Experiments were performed in four in vitro phantoms, two ex vivo porcine liver samples, two ex vivo fatty duck liver samples, and one in vivo fatty goose liver. Successful viscosity maps were reconstructed in homogeneous and heterogeneous phantoms with embedded mechanical inclusions having different geometries. Quantitative values of viscosity obtained for two porcine liver tissues, two fatty duck liver samples, and one goose fatty liver were (mean ± SD) 0.61 ± 0.21, 0.52 ± 0.35; 1.28 ± 0.54, 1.36 ± 0.73, and 1.67 ± 0.70 Pa.s, respectively.
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Ivlev DA, Shirinli SN, Guria KG, Uzlova SG, Guria GT. Control of fibrinolytic drug injection via real-time ultrasonic monitoring of blood coagulation. PLoS One 2019; 14:e0211646. [PMID: 30811424 PMCID: PMC6392241 DOI: 10.1371/journal.pone.0211646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/17/2019] [Indexed: 12/02/2022] Open
Abstract
In the present study, we investigated the capabilities of a novel ultrasonic approach for real-time control of fibrinolysis under flow conditions. Ultrasonic monitoring was performed in a specially designed experimental in vitro system. Fibrinolytic agents were automatically injected at ultrasonically determined stages of the blood clotting. The following clots dissolution in the system was investigated by means of ultrasonic monitoring. It was shown, that clots resistance to fibrinolysis significantly increases during the first 5 minutes since the formation of primary micro-clots. The efficiency of clot lysis strongly depends on the concentration of the fibrinolytic agent as well as the delay of its injection moment. The ultrasonic method was able to detect the coagulation at early stages, when timely pharmacological intervention can still prevent the formation of macroscopic clots in the experimental system. This result serves as evidence that ultrasonic methods may provide new opportunities for real-time monitoring and the early pharmacological correction of thrombotic complications in clinical practice.
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Affiliation(s)
| | | | | | | | - Georgy Th. Guria
- National Research Center for Hematology, Moscow, Russia
- Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- * E-mail:
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29
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Mercado-Shekhar KP, Kleven RT, Aponte Rivera H, Lewis R, Karani KB, Vos HJ, Abruzzo TA, Haworth KJ, Holland CK. Effect of Clot Stiffness on Recombinant Tissue Plasminogen Activator Lytic Susceptibility in Vitro. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2710-2727. [PMID: 30268531 PMCID: PMC6551517 DOI: 10.1016/j.ultrasmedbio.2018.08.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 08/01/2018] [Accepted: 08/10/2018] [Indexed: 05/05/2023]
Abstract
The lytic recombinant tissue plasminogen activator (rt-PA) is the only drug approved by the Food and Drug Administration for treating ischemic stroke. Less than 40% of patients with large vessel occlusions who are treated with rt-PA have improved blood flow. However, up to 6% of all patients receiving rt-PA develop intracerebral hemorrhage. Predicting the efficacy of rt-PA treatment a priori could help guide therapeutic decision making, such that rt-PA is administered only to those individuals who would benefit from this treatment. Clot composition and structure affect the lytic efficacy of rt-PA and have an impact on elasticity. However, the relationship between clot elasticity and rt-PA lytic susceptibility has not been adequately investigated. The goal of this study was to quantify the relationship between clot elasticity and rt-PA susceptibility in vitro. Human and porcine highly retracted and mildly retracted clots were fabricated in glass pipettes. The rt-PA lytic susceptibility was evaluated in vitro using the percent clot mass loss. The Young's moduli of the clots were estimated using ultrasound-based single-track-location shear wave elasticity imaging. The percent mass loss in mildly retracted porcine and human clots (28.9 ± 6.1% and 45.2 ± 7.1%, respectively) was significantly higher (p < 0.05) than in highly retracted porcine and human clots (10.9 ± 2.1% and 25.5 ± 10.0%, respectively). Furthermore, the Young's moduli of highly retracted porcine and human clots (5.33 ± 0.92 and 3.21 ± 1.97 kPa, respectively) were significantly higher (p < 0.05) than those of mildly retracted porcine and human clots (2.66 ± 0.55 and 0.79 ± 0.21 kPa, respectively). The results revealed an inverse relationship between the percent clot mass loss and Young's modulus. These findings motivate continued investigation of ultrasound-based methods to assess clot stiffness in order to predict rt-PA thrombolytic efficacy.
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Affiliation(s)
- Karla P Mercado-Shekhar
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
| | - Robert T Kleven
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
| | - Hermes Aponte Rivera
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ryden Lewis
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kunal B Karani
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Hendrik J Vos
- Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Todd A Abruzzo
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Kevin J Haworth
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
| | - Christy K Holland
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
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30
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Farsaci F, Tellone E, Galtieri A, Ficarra S. Molecular characterization of a peculiar blood clot fluidification by theoretical thermodynamic models and entropy production study. J Mol Liq 2018. [DOI: 10.1016/j.molliq.2018.06.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Is a dangerous blood clot formation a reversible process? Introduction of new characteristic parameter for thermodynamic clot blood characterization: Possible molecular mechanisms and pathophysiologic applications. J Mol Liq 2018. [DOI: 10.1016/j.molliq.2018.04.071] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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32
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Hong X, Annamalai RT, Kemerer TS, Deng CX, Stegemann JP. Multimode ultrasound viscoelastography for three-dimensional interrogation of microscale mechanical properties in heterogeneous biomaterials. Biomaterials 2018; 178:11-22. [PMID: 29902533 DOI: 10.1016/j.biomaterials.2018.05.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/02/2018] [Accepted: 05/31/2018] [Indexed: 02/07/2023]
Abstract
Both static and time-dependent mechanical factors can have a profound impact on cell and tissue function, but it is challenging to measure the mechanical properties of soft materials at the scale which cells sense. Multimode ultrasound viscoelastography (MUVE) uses focused ultrasound pulses to both generate and image deformations within soft hydrogels non-invasively, at sub-millimeter resolution, and in 3D. The deformation and strain over time data are used to extract quantitative parameters that describe both the elastic and viscoelastic properties of the material. MUVE was used in creep mode to characterize the viscoelastic properties of 3D agarose, collagen, and fibrin hydrogels. Quantitative comparisons were made by extracting characteristic viscoelastic parameters using Burger's lumped parameter constitutive model. Spatial resolution of the MUVE technique was found to be approximately 200 μm, while detection sensitivity, defined as the capability to differentiate between materials based on mechanical property differences, was approximately 0.2 kPa using agarose hydrogels. MUVE was superior to nanoindentation and shear rheometry in generating consistent microscale measurements of viscoelastic behavior in soft materials. These results demonstrate that MUVE is a rapid, quantitative, and accurate method to measure the viscoelastic mechanical properties of soft 3D hydrogels at the microscale, and is a promising technique to study the development of native and engineered tissues over time.
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Affiliation(s)
- Xiaowei Hong
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Boulevard, Ann Arbor, MI, MI 48109, USA
| | - Ramkumar T Annamalai
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Boulevard, Ann Arbor, MI, MI 48109, USA
| | - Tyler S Kemerer
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Boulevard, Ann Arbor, MI, MI 48109, USA
| | - Cheri X Deng
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Boulevard, Ann Arbor, MI, MI 48109, USA.
| | - Jan P Stegemann
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Boulevard, Ann Arbor, MI, MI 48109, USA.
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Bader KB. The influence of medium elasticity on the prediction of histotripsy-induced bubble expansion and erythrocyte viability. Phys Med Biol 2018; 63:095010. [PMID: 29553049 PMCID: PMC5959013 DOI: 10.1088/1361-6560/aab79b] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Histotripsy is a form of therapeutic ultrasound that liquefies tissue mechanically via acoustic cavitation. Bubble expansion is paramount in the efficacy of histotripsy therapy, and the cavitation dynamics are strongly influenced by the medium elasticity. In this study, an analytic model to predict histotripsy-induced bubble expansion in a fluid was extended to include the effects of medium elasticity. Good agreement was observed between the predictions of the analytic model and numerical computations utilizing highly nonlinear excitations (shock-scattering histotripsy) and purely tensile pulses (microtripsy). No bubble expansion was computed for either form of histotripsy when the elastic modulus was greater than 20 MPa and the peak negative pressure was less than 50 MPa. Strain in the medium due to the expansion of a single bubble was also tabulated. The viability of red blood cells was calculated as a function of distance from the bubble wall based on empirical data of impulsive stretching of erythrocytes. Red blood cells remained viable at distances further than 44 µm from the bubble wall. As the medium elasticity increased, the distance over which bubble expansion-induced strain influenced red blood cells was found to decrease sigmoidally. These results highlight the relationship between tissue elasticity and the efficacy of histotripsy. In addition, an upper medium elasticity limit was identified, above which histotripsy may not be effective for tissue liquefaction.
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Affiliation(s)
- Kenneth B Bader
- Department of Radiology and the Committee on Medical Physics, University of Chicago, Chicago, IL, United States of America
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34
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The Mechanical Characterisation of Bovine Embolus Analogues Under Various Loading Conditions. Cardiovasc Eng Technol 2018; 9:489-502. [DOI: 10.1007/s13239-018-0352-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/22/2018] [Indexed: 10/17/2022]
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35
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Bhatt M, Montagnon E, Destrempes F, Chayer B, Kazemirad S, Cloutier G. Acoustic radiation force induced resonance elastography of coagulating blood: theoretical viscoelasticity modeling and ex-vivo experimentation. Phys Med Biol 2018; 63:065018. [PMID: 29509143 DOI: 10.1088/1361-6560/aab46a] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Deep vein thrombosis is a common vascular disease that can lead to pulmonary embolism and death. The early diagnosis and clot age staging are important parameters for reliable therapy planning. This article presents an acoustic radiation force induced resonance elastography method for the viscoelastic characterization of clotting blood. The physical concept of this method relies on the mechanical resonance of the blood clot occurring at specific frequencies. Resonances are induced by focusing ultrasound beams inside the sample under investigation. Coupled to an analytical model of wave scattering, the ability of the proposed method to characterize the viscoelasticity of a mimicked venous thrombosis in the acute phase is demonstrated. Experiments with a gelatin-agar inclusion sample of known viscoelasticity are performed for validation and establishment of the proof of concept. In addition, an inversion method is applied in-vitro for the kinetic monitoring of the blood coagulation process of six human blood samples obtained from two volunteers. The computed elasticity and viscosity values of blood samples at the end of the 90 min kinetics were estimated at 411 ± 71 Pa and 0.25 ± 0.03 Pa.s for volunteer #1, and 387 ± 35 Pa and 0.23 ± 0.02 Pa.s for volunteer #2, respectively. The proposed method allowed reproducible time-varying thrombus viscoelastic measurements from samples having physiological dimensions.
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Affiliation(s)
- Manish Bhatt
- Centre Hospitalier de L'Universite de Montreal, Montreal, Quebec, H2W 1T8, CANADA
| | - Emmanuel Montagnon
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montreal, Quebec, CANADA
| | - Francois Destrempes
- Laboratory of Biorheology and Medical Ultrasonics Research Center Univeristy of Montreal Hospital, Universite de Montreal, Montreal, CANADA
| | - Boris Chayer
- University of Montreal Hospital Research Center, Montreal, CANADA
| | - Siavash Kazemirad
- Iran University of Science and Technology, Tehran, Tehran, Iran (the Islamic Republic of)
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics , University of Montreal Hospital Research Center, 900 St-Denis, Montreal, Quebec, CANADA
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36
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Review of Mechanical Testing and Modelling of Thrombus Material for Vascular Implant and Device Design. Ann Biomed Eng 2017; 45:2494-2508. [DOI: 10.1007/s10439-017-1906-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 08/16/2017] [Indexed: 10/19/2022]
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37
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Liu X, Li N, Wen C. Effect of pathological heterogeneity on shear wave elasticity imaging in the staging of deep venous thrombosis. PLoS One 2017; 12:e0179103. [PMID: 28614362 PMCID: PMC5470690 DOI: 10.1371/journal.pone.0179103] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 05/24/2017] [Indexed: 11/27/2022] Open
Abstract
Background We aimed to observe the relationship between the pathological components of a deep venous thrombus (DVT), which was divided into three parts, and the findings on quantitative ultrasonic shear wave elastography (SWE) to increase the accuracy of thrombus staging in a rabbit model. Methods A flow stenosis-induced vein thrombosis model was used, and the thrombus was divided into three parts (head, body and tail), which were associated with corresponding observation points. Elasticity was quantified in vivo using SWE over a 2-week period. A quantitative pathologic image analysis (QPIA) was performed to obtain the relative percentages of the components of the main clots. Results DVT maturity occurred at 2 weeks, and the elasticity of the whole thrombus and the three parts (head, body and tail) showed an increasing trend, with the Young's modulus values varying from 2.36 ± 0.41 kPa to 13.24 ± 1.71 kPa; 2.01 ± 0.28 kPa to 13.29 ± 1.48 kPa; 3.27 ± 0.57 kPa to 15.91 ± 2.05 kPa; and 1.79 ± 0.36 kPa to 10.51 ± 1.61 kPa, respectively. Significant increases occurred on different days for the different parts: the head showed significant increases on days 4 and 6; the body showed significant increases on days 4 and 7; and the tail showed significant increases on days 3 and 6. The QPIA showed that the thrombus composition changed dynamically as the thrombus matured, with the fibrin and calcium salt deposition gradually increasing and the red blood cells (RBCs) and platelet trabecula gradually decreasing. Significant changes were observed on days 4 and 7, which may represent the transition points for acute, sub-acute and chronic thrombi. Significant heterogeneity was observed between and within the thrombi. Conclusions Variations in the thrombus components were generally consistent between the SWE and QPIA. Days 4 and 7 after thrombus induction may represent the transition points for acute, sub-acute and chronic thrombi in rabbit models. A dynamic examination of the same part of the thrombus may be helpful for improving the sensitivity and reproducibility of SWE for DVT diagnosis and staging.
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Affiliation(s)
- Xiaona Liu
- Chinese PLA (People's Liberation Army) Medical School, Beijing, P.R. China
- Department of Ultrasound, Binzhou Medical University Hospital, Binzhou, Shandong, P.R. China
| | - Na Li
- Chinese PLA (People's Liberation Army) Medical School, Beijing, P.R. China
- Department of Auxiliary Diagnosis, The 463rd Hospital of Shenyang Military Region, Shenyang, Liaoning, P.R. China
| | - Chaoyang Wen
- Chinese PLA (People's Liberation Army) Medical School, Beijing, P.R. China
- Department of Ultrasound, The First Affiliated Hospital of Chinese PLA General Hospital, Beijing, P.R. China
- * E-mail:
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38
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Júnior JFSC, Parcero GC, Machado JC. Comparison analysis of four processing methods employed in dynamic elastography to estimate viscoelastic parameters of a medium: tests using computational simulation and experiment. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa61b9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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39
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Zhang HM, Wang Y, Fatemi M, Insana MF. Assessing composition and structure of soft biphasic media from Kelvin-Voigt fractional derivative model parameters. MEASUREMENT SCIENCE & TECHNOLOGY 2017; 28:035703. [PMID: 28239236 PMCID: PMC5319561 DOI: 10.1088/1361-6501/aa5531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Kelvin-Voigt fractional derivative (KVFD) model parameters have been used to describe viscoelastic properties of soft tissues. However, translating model parameters into a concise set of intrinsic mechanical properties related to tissue composition and structure remains challenging. This paper begins by exploring these relationships using a biphasic emulsion materials with known composition. Mechanical properties are measured by analyzing data from two indentation techniques - ramp-stress relaxation and load-unload hysteresis tests. Material composition is predictably correlated with viscoelastic model parameters. Model parameters estimated from the tests reveal that elastic modulus E0 closely approximates the shear modulus for pure gelatin. Fractional-order parameter α and time constant τ vary monotonically with the volume fraction of the material's fluid component. α characterizes medium fluidity and the rate of energy dissipation, and τ is a viscous time constant. Numerical simulations suggest that the viscous coefficient η is proportional to the energy lost during quasi-static force-displacement cycles, EA . The slope of EA versus η is determined by α and the applied indentation ramp time Tr. Experimental measurements from phantom and ex vivo liver data show close agreement with theoretical predictions of the η - EA relation. The relative error is less than 20% for emulsions 22% for liver. We find that KVFD model parameters form a concise features space for biphasic medium characterization that described time-varying mechanical properties.
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Affiliation(s)
- Hong Mei Zhang
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, School of Life Science and Technology, Xi'an JiaoTong University, Xianning West Road No.28, Xi'an, Shaanxi, 710049, P. R. China; Department of Bioengineering and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana IL, 61801, USA
| | - Yue Wang
- Department of Bioengineering and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana IL, 61801, USA
| | - Mostafa Fatemi
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Michael F Insana
- Department of Bioengineering and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana IL, 61801, USA
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Lin H, Shen Y, Chen X, Zhu Y, Zheng Y, Zhang X, Guo Y, Wang T, Chen S. Viscoelastic properties of normal rat liver measured by ultrasound elastography: Comparison with oscillatory rheometry. Biorheology 2016; 53:193-207. [PMID: 27858670 DOI: 10.3233/bir-16091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Ultrasound elastography has been widely used to measure liver stiffness. However, the accuracy of liver viscoelasticity obtained by ultrasound elastography has not been well established. OBJECTIVE To assess the accuracy of ultrasound elastography for measuring liver viscoelasticity and compare to conventional rheometry methods. In addition, to determine if combining these two methods could delineate the rheological behavior of liver over a wide range of frequencies. METHODS The phase velocities of shear waves were measured in livers over a frequency range from 100 to 400 Hz using the ultrasound elastography method of shearwave dispersion ultrasound vibrometry (SDUV), while the complex shear moduli were obtained by rheometry over a frequency range of 1 to 30 Hz. Three rheological models, Maxwell, Voigt, and Zener, were fit to the measured data obtained from the two separate methods and from the combination of the two methods. RESULTS The elasticity measured by SDUV was in good agreement with that of rheometry. However, the viscosity measured by SDUV was significantly different from that of rheometry. CONCLUSIONS The results indicate that the high frequency components of the dispersive data play a much more important role in determining the dispersive pattern or the viscous value than the low frequency components. It was found that the Maxwell model is not as appropriate as the Voigt and Zener models for describing the rheological behavior of liver.
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Affiliation(s)
- Haoming Lin
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Yuanyuan Shen
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Xin Chen
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Ying Zhu
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Yi Zheng
- Department of Electrical and Computer Engineering, St. Cloud State University, St. Cloud, MN, 56301, USA
| | - Xinyu Zhang
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Yanrong Guo
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Tianfu Wang
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Siping Chen
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
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Schwartz BL, Yin Z, Yasar TK, Liu Y, Khan AA, Ye AQ, Royston TJ, Magin RL. Scattering and Diffraction of Elastodynamic Waves in a Concentric Cylindrical Phantom for MR Elastography. IEEE Trans Biomed Eng 2016; 63:2308-2316. [PMID: 26886963 DOI: 10.1109/tbme.2016.2527825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AIM The focus of this paper is to report on the design and construction of a multiply connected phantom for use in magnetic resonance elastography (MRE)-an imaging technique that allows for the noninvasive visualization of the displacement field throughout an object from externally driven harmonic motion-as well as its inverse modeling with a closed-form analytic solution which is derived herein from first principles. METHODS Mathematically, the phantom is described as two infinite concentric circular cylinders with unequal complex shear moduli, harmonically vibrated at the exterior surface in a direction along their common axis. Each concentric cylinder is made of a hydrocolloid with its own specific solute concentration. They are assembled in a multistep process for which custom scaffolding was designed and built. A customized spin-echo-based MR elastography sequence with a sinusoidal motion-sensitizing gradient was used for data acquisition on a 9.4 T Agilent small-animal MR scanner. Complex moduli obtained from the inverse model are used to solve the forward problem with a finite-element method. RESULTS Both complex shear moduli show a significant frequency dependence (p 0.001) in keeping with previous work. CONCLUSION The novel multiply connected phantom and mathematical model are validated as a viable tool for MRE studies. SIGNIFICANCE On a small enough scale much of physiology can be mathematically modeled with basic geometric shapes, e.g., a cylinder representing a blood vessel. This study demonstrates the possibility of elegant mathematical analysis of phantoms specifically designed and carefully constructed for biomedical MRE studies.
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Kazemirad S, Bernard S, Hybois S, Tang A, Cloutier G. Ultrasound Shear Wave Viscoelastography: Model-Independent Quantification of the Complex Shear Modulus. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2016; 63:1399-1408. [PMID: 27362951 DOI: 10.1109/tuffc.2016.2583785] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Ultrasound shear wave elastography methods are commonly used for estimation of mechanical properties of soft biological tissues in diagnostic medicine. A limitation of most currently used elastography methods is that they yield only the shear storage modulus ( G' ) but not the loss modulus ( G'' ). Therefore, no information on viscosity or loss tangent (tan δ) is provided. In this paper, an ultrasound shear wave viscoelastography method is developed for model-independent quantification of frequency-dependent viscoelastic complex shear modulus of macroscopically homogeneous tissues. Three in vitro tissue-mimicking phantoms and two ex vivo porcine liver samples were evaluated. Shear waves were remotely induced within the samples using several acoustic radiation force pushes to generate a semicylindrical wave field similar to those generated by most clinically used elastography systems. The complex shear modulus was estimated over a broad frequency range (up to 1000 Hz) through the analytical solution of the developed inverse wave propagation problem using the measured shear wave speed and amplitude decay versus propagation distance. The shear storage and loss moduli obtained for the in vitro phantoms were compared with those from a planar shear wave method and the average differences over the whole frequency range studied were smaller than 7% and 15%, respectively. The reliability of the proposed method highlights its potential for viscoelastic tissue characterization, which may improve noninvasive diagnosis.
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Abstract
The prevalence of prosthodontic treatment has been well recognized, and the need is continuously increasing with the ageing population. While the oral mucosa plays a critical role in the treatment outcome, the associated biomechanics is not yet fully understood. Using the literature available, this paper provides a critical review on four aspects of mucosal biomechanics, including static, dynamic, volumetric and interactive responses, which are interpreted by its elasticity, viscosity/permeability, apparent Poisson's ratio and friction coefficient, respectively. Both empirical studies and numerical models are analysed and compared to gain anatomical and physiological insights. Furthermore, the clinical applications of such biomechanical knowledge on the mucosa are explored to address some critical concerns, including stimuli for tissue remodelling (interstitial hydrostatic pressure), pressure–pain thresholds, tissue displaceability and residual bone resorption. Through this review, the state of the art in mucosal biomechanics and their clinical implications are discussed for future research interests, including clinical applications, computational modelling, design optimization and prosthetic fabrication.
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Affiliation(s)
- Junning Chen
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Rohana Ahmad
- Unit of Prosthodontics, Faculty of Dentistry, Universiti Teknologi MARA, Shah Alam 40450, Malaysia
| | - Wei Li
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Michael Swain
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
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van Kempen THS, Donders WP, van de Vosse FN, Peters GWM. A constitutive model for developing blood clots with various compositions and their nonlinear viscoelastic behavior. Biomech Model Mechanobiol 2016; 15:279-91. [PMID: 26045142 PMCID: PMC4792371 DOI: 10.1007/s10237-015-0686-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 05/16/2015] [Indexed: 01/19/2023]
Abstract
The mechanical properties determine to a large extent the functioning of a blood clot. These properties depend on the composition of the clot and have been related to many diseases. However, the various involved components and their complex interactions make it difficult at this stage to fully understand and predict properties as a function of the components. Therefore, in this study, a constitutive model is developed that describes the viscoelastic behavior of blood clots with various compositions. Hereto, clots are formed from whole blood, platelet-rich plasma and platelet-poor plasma to study the influence of red blood cells, platelets and fibrin, respectively. Rheological experiments are performed to probe the mechanical behavior of the clots during their formation. The nonlinear viscoelastic behavior of the mature clots is characterized using a large amplitude oscillatory shear deformation. The model is based on a generalized Maxwell model that accurately describes the results for the different rheological experiments by making the moduli and viscosities a function of time and the past and current deformation. Using the same model with different parameter values enables a description of clots with different compositions. A sensitivity analysis is applied to study the influence of parameter variations on the model output. The relative simplicity and flexibility make the model suitable for numerical simulations of blood clots and other materials showing similar behavior.
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Affiliation(s)
- Thomas H S van Kempen
- Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600MB, Eindhoven, The Netherlands.
| | - Wouter P Donders
- Department of Biomedical Engineering, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans N van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600MB, Eindhoven, The Netherlands
| | - Gerrit W M Peters
- Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Ouared A, Montagnon E, Cloutier G. Generation of remote adaptive torsional shear waves with an octagonal phased array to enhance displacements and reduce variability of shear wave speeds: comparison with quasi-plane shear wavefronts. Phys Med Biol 2015; 60:8161-85. [DOI: 10.1088/0031-9155/60/20/8161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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46
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Solomon C, Ranucci M, Hochleitner G, Schöchl H, Schlimp CJ. Assessing the Methodology for Calculating Platelet Contribution to Clot Strength (Platelet Component) in Thromboelastometry and Thrombelastography. Anesth Analg 2015; 121:868-878. [PMID: 26378699 PMCID: PMC4568902 DOI: 10.1213/ane.0000000000000859] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 12/28/2022]
Abstract
The viscoelastic properties of blood clot have been studied most commonly using thrombelastography (TEG) and thromboelastometry (ROTEM). ROTEM-based bleeding treatment algorithms recommend administering platelets to patients with low EXTEM clot strength (e.g., clot amplitude at 10 minutes [A10] <40 mm) once clot strength of the ROTEM® fibrin-based test (FIBTEM) is corrected. Algorithms based on TEG typically use a low value of maximum amplitude (e.g., <50 mm) as a trigger for administering platelets. However, this parameter reflects the contributions of various blood components to the clot, including platelets and fibrin/fibrinogen. The platelet component of clot strength may provide a more sensitive indication of platelet deficiency than clot amplitude from a whole blood TEG or ROTEM® assay. The platelet component of the formed clot is derived from the results of TEG/ROTEM® tests performed with and without platelet inhibition. In this article, we review the basis for why this calculation should be based on clot elasticity (e.g., the E parameter with TEG and the CE parameter with ROTEM®) as opposed to clot amplitude (e.g., the A parameter with TEG or ROTEM®). This is because clot elasticity, unlike clot amplitude, reflects the force with which the blood clot resists rotation within the device, and the relationship between clot amplitude (variable X) and clot elasticity (variable Y) is nonlinear. A specific increment of X (ΔX) will be associated with different increments of Y (ΔY), depending on the initial value of X. When calculated correctly, using clot elasticity data, the platelet component of the clot can provide a valuable insight into platelet deficiency in emergency bleeding.
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Affiliation(s)
- Cristina Solomon
- From the CSL Behring, Marburg, Germany; Department of Anesthesiology, Perioperative Care and General Intensive Care, Paracelsus Medical University, Salzburg University Hospital, Salzburg, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology and AUVA Research Centre, Vienna, Austria; Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Policlinico, San Donato, Milan, Italy; CSL Behring, Vienna, Austria and Department of Anesthesiology and Intensive Care, AUVA Trauma Hospital of Salzburg, Austria
| | - Marco Ranucci
- From the CSL Behring, Marburg, Germany; Department of Anesthesiology, Perioperative Care and General Intensive Care, Paracelsus Medical University, Salzburg University Hospital, Salzburg, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology and AUVA Research Centre, Vienna, Austria; Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Policlinico, San Donato, Milan, Italy; CSL Behring, Vienna, Austria and Department of Anesthesiology and Intensive Care, AUVA Trauma Hospital of Salzburg, Austria
| | - Gerald Hochleitner
- From the CSL Behring, Marburg, Germany; Department of Anesthesiology, Perioperative Care and General Intensive Care, Paracelsus Medical University, Salzburg University Hospital, Salzburg, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology and AUVA Research Centre, Vienna, Austria; Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Policlinico, San Donato, Milan, Italy; CSL Behring, Vienna, Austria and Department of Anesthesiology and Intensive Care, AUVA Trauma Hospital of Salzburg, Austria
| | - Herbert Schöchl
- From the CSL Behring, Marburg, Germany; Department of Anesthesiology, Perioperative Care and General Intensive Care, Paracelsus Medical University, Salzburg University Hospital, Salzburg, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology and AUVA Research Centre, Vienna, Austria; Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Policlinico, San Donato, Milan, Italy; CSL Behring, Vienna, Austria and Department of Anesthesiology and Intensive Care, AUVA Trauma Hospital of Salzburg, Austria
| | - Christoph J. Schlimp
- From the CSL Behring, Marburg, Germany; Department of Anesthesiology, Perioperative Care and General Intensive Care, Paracelsus Medical University, Salzburg University Hospital, Salzburg, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology and AUVA Research Centre, Vienna, Austria; Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Policlinico, San Donato, Milan, Italy; CSL Behring, Vienna, Austria and Department of Anesthesiology and Intensive Care, AUVA Trauma Hospital of Salzburg, Austria
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Carstensen EL, Parker KJ. Oestreicher and elastography. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2015; 138:2317-25. [PMID: 26520312 DOI: 10.1121/1.4930953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A sphere moving back and forth in tissue generates the kinds of complex displacement fields that are used in elastography. The analytical solution of Hans Oestreicher for this phenomenon [(1951). J. Acoust. Soc. Am. 23, 704-714] gives an understanding of the transverse and longitudinal, fast and slow waves that are generated. The results suggest several ways to determine the absorption coefficients of tissues, which together with phase velocity permit the computation of both the real shear modulus and the shear viscosity as functions of frequency.
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Affiliation(s)
- Edwin L Carstensen
- Departments of Electrical & Computer and of Biomedical Engineering, University of Rochester, Rochester, New York 14627, USA
| | - Kevin J Parker
- Departments of Electrical & Computer and of Biomedical Engineering, University of Rochester, Rochester, New York 14627, USA
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Sonic Estimation of Elasticity via Resonance: A New Method of Assessing Hemostasis. Ann Biomed Eng 2015; 44:1405-24. [PMID: 26399992 DOI: 10.1007/s10439-015-1460-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/13/2015] [Indexed: 10/23/2022]
Abstract
Uncontrolled bleeding threatens patients undergoing major surgery and in care for traumatic injury. This paper describes a novel method of diagnosing coagulation dysfunction by repeatedly measuring the shear modulus of a blood sample as it clots in vitro. Each measurement applies a high-energy ultrasound pulse to induce a shear wave within a rigid walled chamber, and then uses low energy ultrasound pulses to measure displacements associated with the resonance of that shear wave. Measured displacements are correlated with predictions from finite difference time domain models, with the best fit corresponding to the modulus estimate. In our current implementation each measurement requires 62.4 ms. Experimental data was analyzed using a fixed-viscosity algorithm and a free-viscosity algorithm. In experiments utilizing human blood induced to clot by exposure to kaolin, the free-viscosity algorithm quantified the shear modulus of formed clots with a worst-case precision of 2.5%. Precision was improved to 1.8% by utilizing the fixed-viscosity algorithm. Repeated measurements showed a smooth evolution from liquid blood to a firm clot with a shear modulus between 1.4 and 3.3 kPa. These results show the promise of this technique for rapid, point of care assessment of coagulation.
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49
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Wang CW, Perez MJ, Helmke BP, Viola F, Lawrence MB. Integration of acoustic radiation force and optical imaging for blood plasma clot stiffness measurement. PLoS One 2015; 10:e0128799. [PMID: 26042775 PMCID: PMC4456080 DOI: 10.1371/journal.pone.0128799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 04/30/2015] [Indexed: 01/22/2023] Open
Abstract
Despite the life-preserving function blood clotting serves in the body, inadequate or excessive blood clot stiffness has been associated with life-threatening diseases such as stroke, hemorrhage, and heart attack. The relationship between blood clot stiffness and vascular diseases underscores the importance of quantifying the magnitude and kinetics of blood's transformation from a fluid to a viscoelastic solid. To measure blood plasma clot stiffness, we have developed a method that uses ultrasound acoustic radiation force (ARF) to induce micron-scaled displacements (1-500 μm) on microbeads suspended in blood plasma. The displacements were detected by optical microscopy and took place within a micro-liter sized clot region formed within a larger volume (2 mL sample) to minimize container surface effects. Modulation of the ultrasound generated acoustic radiation force allowed stiffness measurements to be made in blood plasma from before its gel point to the stage where it was a fully developed viscoelastic solid. A 0.5 wt % agarose hydrogel was 9.8-fold stiffer than the plasma (platelet-rich) clot at 1 h post-kaolin stimulus. The acoustic radiation force microbead method was sensitive to the presence of platelets and strength of coagulation stimulus. Platelet depletion reduced clot stiffness 6.9 fold relative to platelet rich plasma. The sensitivity of acoustic radiation force based stiffness assessment may allow for studying platelet regulation of both incipient and mature clot mechanical properties.
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Affiliation(s)
- Caroline W. Wang
- Department of Biomedical Engineering, School of Engineering and Applied Science and School of Medicine, University of Virginia Health System, Charlottesville, Virginia, United States of America
| | - Matthew J. Perez
- Department of Biomedical Engineering, School of Engineering and Applied Science and School of Medicine, University of Virginia Health System, Charlottesville, Virginia, United States of America
| | - Brian P. Helmke
- Department of Biomedical Engineering, School of Engineering and Applied Science and School of Medicine, University of Virginia Health System, Charlottesville, Virginia, United States of America
| | - Francesco Viola
- HemoSonics, LLC, Charlottesville, Virginia, United States of America
| | - Michael B. Lawrence
- Department of Biomedical Engineering, School of Engineering and Applied Science and School of Medicine, University of Virginia Health System, Charlottesville, Virginia, United States of America
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50
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Vappou J, Hou GY, Marquet F, Shahmirzadi D, Grondin J, Konofagou EE. Non-contact, ultrasound-based indentation method for measuring elastic properties of biological tissues using harmonic motion imaging (HMI). Phys Med Biol 2015; 60:2853-68. [PMID: 25776065 DOI: 10.1088/0031-9155/60/7/2853] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Noninvasive measurement of mechanical properties of biological tissues in vivo could play a significant role in improving the current understanding of tissue biomechanics. In this study, we propose a method for measuring elastic properties non-invasively by using internal indentation as generated by harmonic motion imaging (HMI). In HMI, an oscillating acoustic radiation force is produced by a focused ultrasound transducer at the focal region, and the resulting displacements are estimated by tracking radiofrequency signals acquired by an imaging transducer. In this study, the focal spot region was modeled as a rigid cylindrical piston that exerts an oscillatory, uniform internal force to the underlying tissue. The HMI elastic modulus EHMI was defined as the ratio of the applied force to the axial strain measured by 1D ultrasound imaging. The accuracy and the precision of the EHMI estimate were assessed both numerically and experimentally in polyacrylamide tissue-mimicking phantoms. Initial feasibility of this method in soft tissues was also shown in canine liver specimens in vitro. Very good correlation and agreement was found between the measured Young's modulus and the HMI modulus in the numerical study (r(2) > 0.99, relative error <10%) and on polyacrylamide gels (r(2) = 0.95, relative error <24%). The average HMI modulus on five liver samples was found to EHMI = 2.62 ± 0.41 kPa, compared to EMechTesting = 4.2 ± 2.58 kPa measured by rheometry. This study has demonstrated for the first time the initial feasibility of a non-invasive, model-independent method to estimate local elastic properties of biological tissues at a submillimeter scale using an internal indentation-like approach. Ongoing studies include in vitro experiments in a larger number of samples and feasibility testing in in vivo models as well as pathological human specimens.
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Affiliation(s)
- Jonathan Vappou
- ICube, Université de Strasbourg, CNRS, France. Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
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