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Ponomarchuk EM, Rosnitskiy PB, Tsysar SA, Khokhlova TD, Karzova MM, Kvashennikova AV, Tumanova KD, Kadrev AV, Buravkov SV, Trakhtman PE, Starostin NN, Sapozhnikov OA, Khokhlova VA. Elastic Properties of Aging Human Hematoma Model In Vitro and Its Susceptibility to Histotripsy Liquefaction. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:927-938. [PMID: 38514363 DOI: 10.1016/j.ultrasmedbio.2024.02.019] [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: 10/10/2023] [Revised: 02/10/2024] [Accepted: 02/26/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Tissue susceptibility to histotripsy disintegration has been reported to depend on its elastic properties. This work was aimed at investigation of histotripsy efficiency for liquefaction of human hematomas, depending on their stiffness and degree of retraction over time (0-10 d). METHODS As an in vitro hematoma model, anticoagulated human blood samples (200 mL) were recalcified at different temperatures. In one set of samples, the shear modulus was measured by shear wave elastography during blood clotting at 10℃, 22℃ and 37℃, and then daily during further aging. The ultrastructure of the samples was analyzed daily with scanning electron microscopy (SEM). Another set of blood samples (50-200 mL) were recalcified at 37℃ for density and retraction measurements over aging and exposed to histotripsy at varying time points. Boiling histotripsy (2.5 ms pulses) and hybrid histotripsy (0.2 ms pulses) exposures (2 MHz, 1% dc, P+/P-/As = 182/-27/207 MPa in situ) were used to produce either individual cigar-shaped or volumetric (0.8-3 mL) lesions in samples incubated for 3 h, 5 d and 10 d. The obtained lesions were sized, then the lysate aspirated under B-mode guidance was analyzed ultrastructurally and diluted in distilled water for sizing of residual fragments. RESULTS It was found that clotting time decreased from 113 to 25 min with the increase in blood temperature from 10℃ to 37℃. The shear modulus increased to 0.53 ± 0.17 kPa during clotting and remained constant within 8 d of incubation at 2℃. Sample volumes decreased by 57% because of retraction within 10 d. SEM revealed significant echinocytosis but unchanged ultrastructure of the fibrin meshwork. Liquefaction rate and lesion dimensions produced with the same histotripsy protocols correlated with the increase in the degree of retraction and were lower in retracted samples versus freshly clotted samples. More than 80% of residual fibrin fragments after histotripsy treatment were shorter than 150 µm; the maximum length was 208 µm, allowing for unobstructed aspiration of the lysate with most clinically used needles. CONCLUSION The results indicate that hematoma susceptibility to histotripsy liquefaction is not entirely determined by its stiffness, and correlates with the retraction degree.
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Affiliation(s)
| | - Pavel B Rosnitskiy
- Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Sergey A Tsysar
- Physics Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Tatiana D Khokhlova
- Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Maria M Karzova
- Physics Faculty, Lomonosov Moscow State University, Moscow, Russia
| | | | | | - Alexey V Kadrev
- Department of Urology and Andrology, Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia; Diagnostic Ultrasound Division, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Sergey V Buravkov
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Pavel E Trakhtman
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Nicolay N Starostin
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Oleg A Sapozhnikov
- Physics Faculty, Lomonosov Moscow State University, Moscow, Russia; Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Vera A Khokhlova
- Physics Faculty, Lomonosov Moscow State University, Moscow, Russia; Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
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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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Biswas D, Heo J, Sang P, Dey P, Han K, Ko JH, Won SM, Son D, Suh M, Kim HS, Ok JG, Park HJ, Baac HW. Micro-ultrasonic Assessment of Early Stage Clot Formation and Whole Blood Coagulation Using an All-Optical Ultrasound Transducer and Adaptive Signal Processing Algorithm. ACS Sens 2022; 7:2940-2950. [PMID: 36107765 DOI: 10.1021/acssensors.2c00875] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Abnormal formation of solid thrombus inside a blood vessel can cause thrombotic morbidity and mortality. This necessitates early stage diagnosis, which requires quantitative assessment with a small volume, for effective therapy with low risk to unwanted development of various diseases. We propose a micro-ultrasonic diagnosis using an all-optical ultrasound-based spectral sensing (AOUSS) technique for sensitive and quantitative characterization of early stage and whole blood coagulation. The AOUSS technique detects and analyzes minute viscoelastic variations of blood at a micro-ultrasonic spot (<100 μm) defined by laser-generated focused ultrasound (LGFU). This utilizes (1) a uniquely designed optical transducer configuration for frequency-spectral matching and wideband operation (6 dB widths: 7-32 MHz and d.c. ∼ 46 MHz, respectively) and (2) an empirical mode decomposition (EMD)-based signal process particularly adapted to nonstationary LGFU signals backscattered from the spot. An EMD-derived spectral analysis enables one to assess viscoelastic variations during the initiation of fibrin formation, which occurs at a very early stage of blood coagulation (1 min) with high sensitivity (frequency transition per storage modulus increment = 8.81 MHz/MPa). Our results exhibit strong agreement with those obtained by conventional rheometry (Pearson's R > 0.95), which are also confirmed by optical microscopy. The micro-ultrasonic and high-sensitivity detection of AOUSS poses a potential clinical significance, serving as a screening modality to diagnose early stage clot formation (e.g., as an indicator for hypercoagulation of blood) and stages of blood-to-clot transition to check a potential risk for development into thrombotic diseases.
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Affiliation(s)
- Deblina Biswas
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea.,School of Bioengineering and Food Technology, Shoolini University, Solan, Himachal Pradesh 173229, India
| | - Jeongmin Heo
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Pilgyu Sang
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Prasanta Dey
- School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Kayoung Han
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Department of Biomedical Engineering, Department of Intelligent Precision Healthcare Convergence (IPHC), Biomedical Institute of Convergence (BICS), Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Jong Hwan Ko
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Sang Min Won
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Donghee Son
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Minah Suh
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Department of Biomedical Engineering, Department of Intelligent Precision Healthcare Convergence (IPHC), Biomedical Institute of Convergence (BICS), Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Hyung Sik Kim
- School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Jong G Ok
- Department of Mechanical and Automotive Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
| | - Hui Joon Park
- Department of Organic and Nano Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyoung Won Baac
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea
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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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Auboire L, Fouan D, Grégoire JM, Ossant F, Plag C, Escoffre JM, Bouakaz A. Acoustic and Elastic Properties of a Blood Clot during Microbubble-Enhanced Sonothrombolysis: Hardening of the Clot with Inertial Cavitation. Pharmaceutics 2021; 13:pharmaceutics13101566. [PMID: 34683859 PMCID: PMC8537785 DOI: 10.3390/pharmaceutics13101566] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
Stroke is the second leading cause of death worldwide. Existing therapies present limitations, and other therapeutic alternatives are sought, such as sonothrombolysis with microbubbles (STL). The aim of this study was to evaluate the change induced by STL with or without recombinant tissue-type plasminogen activator (rtPA) on the acoustic and elastic properties of the blood clot by measuring its sound speed (SoS) and shear wave speed (SWS) with high frequency ultrasound and ultrafast imaging, respectively. An in-vitro setup was used and human blood clots were submitted to a combination of microbubbles and rtPA. The results demonstrate that STL induces a raise of SoS in the blood clot, specifically when combined with rtPA (p < 0.05). Moreover, the combination of rtPA and STL induces a hardening of the clot in comparison to rtPA alone (p < 0.05). This is the first assessment of acoustoelastic properties of blood clots during STL. The combination of rtPA and STL induce SoS and hardening of the clot, which is known to impair the penetration of thrombolytic drugs and their efficacy.
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6
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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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7
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Ponomarchuk EM, Rosnitskiy PB, Khokhlova TD, Buravkov SV, Tsysar SA, Karzova MM, Tumanova KD, Kunturova AV, Wang YN, Sapozhnikov OA, Trakhtman PE, Starostin NN, Khokhlova VA. Ultrastructural Analysis of Volumetric Histotripsy Bio-effects in Large Human Hematomas. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2608-2621. [PMID: 34116880 PMCID: PMC8355095 DOI: 10.1016/j.ultrasmedbio.2021.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
Large-volume soft tissue hematomas are a serious clinical problem, which, if untreated, can have severe consequences. Current treatments are associated with significant pain and discomfort. It has been reported that in an in vitro bovine hematoma model, pulsed high-intensity focused ultrasound (HIFU) ablation, termed histotripsy, can be used to rapidly and non-invasively liquefy the hematoma through localized bubble activity, enabling fine-needle aspiration. The goals of this study were to evaluate the efficiency and speed of volumetric histotripsy liquefaction using a large in vitro human hematoma model. Large human hematoma phantoms (85 cc) were formed by recalcifying blood anticoagulated with citrate phosphate dextrose/saline-adenine-glucose-mannitol solution. Typical boiling histotripsy pulses (10 or 2 ms) or hybrid histotripsy pulses using higher-amplitude and shorter pulses (0.4 ms) were delivered at 1% duty cycle while continuously translating the HIFU focus location. Histotripsy exposures were performed under ultrasound guidance with a 1.5-MHz transducer (8-cm aperture, F# = 0.75). The volume of liquefied lesions was determined by ultrasound imaging and gross inspection. Untreated hematoma samples and samples of the liquefied lesions aspirated using a fine needle were analyzed cytologically and ultrastructurally with scanning electron microscopy. All exposures resulted in uniform liquid-filled voids with sharp edges; liquefaction speed was higher for exposures with shorter pulses and higher shock amplitudes at the focus (up to 0.32, 0.68 and 2.62 mL/min for 10-, 2- and 0.4-ms pulses, respectively). Cytological and ultrastructural observations revealed completely homogenized blood cells and fibrin fragments in the lysate. Most of the fibrin fragments were less than 20 μm in length, but a number of fragments were up to 150 μm. The lysate with residual debris of that size would potentially be amenable to fine-needle aspiration without risk for needle clogging in clinical implementation.
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Affiliation(s)
- Ekaterina M Ponomarchuk
- Laboratory for Industrial and Medical Ultrasound, Physics Faculty, M. V. Lomonosov Moscow State University, Moscow, Russian Federation.
| | - Pavel B Rosnitskiy
- Laboratory for Industrial and Medical Ultrasound, Physics Faculty, M. V. Lomonosov Moscow State University, Moscow, Russian Federation
| | | | - Sergey V Buravkov
- Faculty of Fundamental Medicine, M. V. Lomonosov Moscow State University, Moscow, Russian Federation
| | - Sergey A Tsysar
- Laboratory for Industrial and Medical Ultrasound, Physics Faculty, M. V. Lomonosov Moscow State University, Moscow, Russian Federation
| | - Maria M Karzova
- Laboratory for Industrial and Medical Ultrasound, Physics Faculty, M. V. Lomonosov Moscow State University, Moscow, Russian Federation
| | - Kseniya D Tumanova
- Laboratory for Industrial and Medical Ultrasound, Physics Faculty, M. V. Lomonosov Moscow State University, Moscow, Russian Federation
| | - Anna V Kunturova
- Laboratory for Industrial and Medical Ultrasound, Physics Faculty, M. V. Lomonosov Moscow State University, Moscow, Russian Federation
| | - Y-N Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Oleg A Sapozhnikov
- Laboratory for Industrial and Medical Ultrasound, Physics Faculty, M. V. Lomonosov Moscow State University, Moscow, Russian Federation; Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Pavel E Trakhtman
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Nicolay N Starostin
- National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Vera A Khokhlova
- Laboratory for Industrial and Medical Ultrasound, Physics Faculty, M. V. Lomonosov Moscow State University, Moscow, Russian Federation; Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
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8
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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: 14] [Impact Index Per Article: 4.7] [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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9
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Khokhlova TD, Kucewicz JC, Ponomarchuk EM, Hunter C, Bruce M, Khokhlova VA, Matula TJ, Monsky W. Effect of Stiffness of Large Extravascular Hematomas on Their Susceptibility to Boiling Histotripsy Liquefaction in Vitro. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2007-2016. [PMID: 32444137 PMCID: PMC7360281 DOI: 10.1016/j.ultrasmedbio.2020.04.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/31/2020] [Accepted: 04/20/2020] [Indexed: 05/04/2023]
Abstract
Large intra-abdominal, retroperitoneal and intramuscular hematomas are common consequences of sharp and blunt trauma and post-surgical bleeds, and often threaten organ failure, compartment syndrome or spontaneous infection. Current therapy options include surgical evacuation and placement of indwelling drains that are not effective because of the viscosity of the organized hematoma. We have previously reported the feasibility of using boiling histotripsy (BH)-a pulsed high-intensity focused ultrasound method-for liquefaction of large volumes of freshly coagulated blood and subsequent fine-needle aspiration. The goal of this work was to evaluate the changes in stiffness of large coagulated blood volumes with aging and retraction in vitro, and to correlate these changes with the size of the BH void and, therefore, the susceptibility of the material to BH liquefaction. Large-volume (55-200 mL) whole-blood clots were fabricated in plastic molds from human and bovine blood, either by natural clotting or by recalcification of anticoagulated blood, with or without addition of thrombin. Retraction of the clots was achieved by incubation for 3 h, 3 d or 8 d. The shear modulus of the samples was measured with a custom-built indentometer and shear wave elasticity (SWE) imaging. Sizes of single liquefied lesions produced with a 1.5-MHz high-intensity focused ultrasound transducer within a 30-s standard BH exposure served as the metric for susceptibility of clot material to this treatment. Neither the shear moduli of naturally clotted human samples (0.52 ± 0.08 kPa), nor their degree of retraction (ratio of expelled fluid to original volume 50%-58%) depended on the length of incubation within 0-8 d, and were significantly lower than those of bovine samples (2.85 ± 0.17 kPa, retraction 5%-38%). In clots made from anticoagulated bovine blood, the variation of calcium chloride concentration within 5-40 mmol/L did not change the stiffness, whereas lower concentrations and the addition of thrombin resulted in significantly softer clots, similar to naturally clotted human samples. Within the achievable shear modulus range (0.4-1.6 kPa), the width of the BH-liquefied lesion was more affected by the changes in stiffness than the length of the lesion. In all cases, however, the lesions were larger compared with any soft tissue liquefied with the same BH parameters, indicating higher susceptibility of hematomas to BH damage. These results suggest that clotted bovine blood with added thrombin is an acceptable in vitro model of both acute and chronic human hematomas for assessing the efficiency of BH liquefaction strategies.
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Affiliation(s)
| | - John C Kucewicz
- Center for Industrial and Medical Ultrasound, Applied Physics Lab, University of Washington, Seattle, Washington, USA
| | | | - Christopher Hunter
- Center for Industrial and Medical Ultrasound, Applied Physics Lab, University of Washington, Seattle, Washington, USA
| | - Matthew Bruce
- Center for Industrial and Medical Ultrasound, Applied Physics Lab, University of Washington, Seattle, Washington, USA
| | - Vera A Khokhlova
- Center for Industrial and Medical Ultrasound, Applied Physics Lab, University of Washington, Seattle, Washington, USA; Physics Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Thomas J Matula
- Center for Industrial and Medical Ultrasound, Applied Physics Lab, University of Washington, Seattle, Washington, USA
| | - Wayne Monsky
- Department of Radiology, University of Washington, Seattle, Washington, USA
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10
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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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11
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Czaplicki C, Albadawi H, Partovi S, Gandhi RT, Quencer K, Deipolyi AR, Oklu R. Can thrombus age guide thrombolytic therapy? Cardiovasc Diagn Ther 2017; 7:S186-S196. [PMID: 29399522 DOI: 10.21037/cdt.2017.11.05] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Venous thrombosis (VT) is a common yet complex clinical condition that has shown minimal alteration in clinical management for decades. It is well known that thrombus evolves structurally over time, with complex changes resulting from the interplay between coagulation factors, cytokines, leukocytes and a myriad of other factors. Our current treatment options are most effective in the acute thrombus, which is composed predominantly of a loose mesh of fibrin and red blood cells (RBCs), making current anticoagulation therapies and thrombolytics quite effective in treatment. Later stages of thrombus are more cellular containing leukocytes, and develop a fibrotic collagenous framework that is more resistant to our current treatments. Understanding the biology of an evolving thrombus will allow us to tailor our treatment and optimize outcomes, as well as focus on novel therapies for the treatment of chronic thrombus. Given the morbidity and mortality of both post thrombotic syndrome (PTS) in patients with deep VT, as well as chronic thromboembolic pulmonary hypertension (CTEPH) in patients with pulmonary embolism (PE), new and innovative therapies must continue to be explored to help prevent these potentially devastating conditions.
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Affiliation(s)
| | - Hassan Albadawi
- Division of Vascular & Interventional Radiology, Mayo Clinic, Phoenix, AZ, USA
| | - Sasan Partovi
- University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Ripal T Gandhi
- Miami Cardiac and Vascular Institute, University of South Florida College of Medicine, Kendall, FL, USA
| | - Keith Quencer
- Department of Radiology, University of California San Diego Medical Center, San Diego, CA, USA
| | - Amy R Deipolyi
- Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rahmi Oklu
- Division of Vascular & Interventional Radiology, Mayo Clinic, Phoenix, AZ, USA
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12
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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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13
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Anvari A, Barr RG, Dhyani M, Samir AE. Clinical application of sonoelastography in thyroid, prostate, kidney, pancreas, and deep venous thrombosis. ACTA ACUST UNITED AC 2015; 40:709-22. [PMID: 25750099 DOI: 10.1007/s00261-015-0383-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This article reviews the clinical applications of current ultrasound elastography methods in non-hepatic conditions including thyroid nodules, prostate cancer, chronic kidney disease, solid renal lesions, pancreatic lesions, and deep vein thrombosis. Pathophysiology alters tissue mechanical properties via ultrastructural changes including fibrosis, increased cellularity, bleeding, and necrosis, creating a target biomarker, which can be imaged qualitatively or quantitatively with US elastography. US elastography methods can add information to conventional US methods and improve the diagnostic performance of conventional US in a range of disease processes.
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Affiliation(s)
- Arash Anvari
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
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14
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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: 25] [Impact Index Per Article: 2.8] [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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15
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Wufsus AR, Rana K, Brown A, Dorgan JR, Liberatore MW, Neeves KB. Elastic behavior and platelet retraction in low- and high-density fibrin gels. Biophys J 2015; 108:173-83. [PMID: 25564864 DOI: 10.1016/j.bpj.2014.11.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/06/2014] [Accepted: 11/06/2014] [Indexed: 11/30/2022] Open
Abstract
Fibrin is a biopolymer that gives thrombi the mechanical strength to withstand the forces imparted on them by blood flow. Importantly, fibrin is highly extensible, but strain hardens at low deformation rates. The density of fibrin in clots, especially arterial clots, is higher than that in gels made at plasma concentrations of fibrinogen (3-10 mg/mL), where most rheology studies have been conducted. Our objective in this study was to measure and characterize the elastic regimes of low (3-10 mg/mL) and high (30-100 mg/mL) density fibrin gels using shear and extensional rheology. Confocal microscopy of the gels shows that fiber density increases with fibrinogen concentration. At low strains, fibrin gels act as thermal networks independent of fibrinogen concentration. Within the low-strain regime, one can predict the mesh size of fibrin gels by the elastic modulus using semiflexible polymer theory. Significantly, this provides a link between gel mechanics and interstitial fluid flow. At moderate strains, we find that low-density fibrin gels act as nonaffine mechanical networks and transition to affine mechanical networks with increasing strains within the moderate regime, whereas high-density fibrin gels only act as affine mechanical networks. At high strains, the backbone of individual fibrin fibers stretches for all fibrin gels. Platelets can retract low-density gels by >80% of their initial volumes, but retraction is attenuated in high-density fibrin gels and with decreasing platelet density. Taken together, these results show that the nature of fibrin deformation is a strong function of fibrin fiber density, which has ramifications for the growth, embolization, and lysis of thrombi.
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Affiliation(s)
- Adam R Wufsus
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, Colorado
| | - Kuldeepsinh Rana
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, Colorado
| | - Andrea Brown
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, Colorado
| | - John R Dorgan
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, Colorado
| | - Matthew W Liberatore
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, Colorado
| | - Keith B Neeves
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, Colorado; Department of Pediatrics, University of Colorado, Aurora, Colorado.
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16
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17
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Hernandez-Andrade E, Aurioles-Garibay A, Garcia M, Korzeniewski SJ, Schwartz AG, Ahn H, Martinez-Varea A, Yeo L, Chaiworapongsa T, Hassan SS, Romero R. Effect of depth on shear-wave elastography estimated in the internal and external cervical os during pregnancy. J Perinat Med 2014; 42:549-57. [PMID: 25029081 PMCID: PMC4183447 DOI: 10.1515/jpm-2014-0073] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/19/2014] [Indexed: 12/22/2022]
Abstract
AIM To investigate the effect of depth on cervical shear-wave elastography. METHODS Shear-wave elastography was applied to estimate the velocity of propagation of the acoustic force impulse (shear wave) in the cervix of 154 pregnant women at 11-36 weeks of gestation. Shear-wave speed (SWS) was evaluated in cross-sectional views of the internal and external cervical os in five regions of interest: anterior, posterior, lateral right, lateral left, and endocervix. Distance from the center of the ultrasound (US) transducer to the center of each region of interest was registered. RESULTS In all regions, SWS decreased significantly with gestational age (P=0.006). In the internal os, SWS was similar among the anterior, posterior, and lateral regions and lower in the endocervix. In the external os, the endocervix and anterior regions showed similar SWS values, lower than those from the posterior and lateral regions. In the endocervix, these differences remained significant after adjustment for depth, gestational age, and cervical length. SWS estimations in all regions of the internal os were higher than those of the external os, suggesting denser tissue. CONCLUSION Depth from the US probe to different regions in the cervix did not significantly affect the SWS estimations.
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Affiliation(s)
- Edgar Hernandez-Andrade
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Alma Aurioles-Garibay
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Maynor Garcia
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Steven J. Korzeniewski
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Alyse G. Schwartz
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Hyunyoung Ahn
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Alicia Martinez-Varea
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA
| | - Lami Yeo
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Sonia S. Hassan
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Roberto Romero
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, and Detroit, MI, USA,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
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18
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Gennisson JL, Marcellan A, Dizeux A, Tanter M. Rheology over five orders of magnitude in model hydrogels: agreement between strain-controlled rheometry, transient elastography, and supersonic shear wave imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2014; 61:946-954. [PMID: 24859658 DOI: 10.1109/tuffc.2014.2990] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Shear wave elastography helps physicians to characterize pathologies by assessing biomechanical properties of soft tissues. Compared with classical rheology, these techniques allow the quantification of the mechanical properties of tissues in the frequency range of hundreds of hertz. In this paper, ultrasound elastographic measurements and classical rheology are compared over a frequency range spanning five orders of magnitude [0.01 to 1200 Hz] to characterize model gels at multiple scales. Hybrid hydrogels were specially synthesized to get a fine tuning of the material dissipative response. Strain-controlled rheology (SCR) experiments were performed to get the elastic moduli G" and loss moduli G" from 0.01 Hz to 10 Hz and were confirmed by tensile tests. Transient elastography (TE from 50 to 400 Hz) and supersonic shear imaging (SSI from 200 to 1200 Hz) were used to characterize polymers at high frequency. Two different hydrogels were tested in the ultrasound setup with different concentration of scatterers. From low-frequency measurements, elastic moduli were extrapolated at high frequency and a very good correlation was obtained between SCR and TE and between SCR and SSI (r = 0.92 and r = 0.95, respectively). This paper demonstrates the capability of shear wave elastography to accurately image rheological properties of soft tissues, to differentiate soft elastic domains from viscous ones. It also gives new insights into soft material science because it provides a rheological tool in a high-frequency domain complementary to conventional rheometry.
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19
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Ramnarine KV, Garrard JW, Dexter K, Nduwayo S, Panerai RB, Robinson TG. Shear wave elastography assessment of carotid plaque stiffness: in vitro reproducibility study. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:200-209. [PMID: 24210861 DOI: 10.1016/j.ultrasmedbio.2013.09.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 08/19/2013] [Accepted: 09/09/2013] [Indexed: 06/02/2023]
Abstract
This study assessed inter- and intra-observer reproducibility of shear wave elastography (SWE) measurements in vessel phantoms simulating soft and hard carotid plaque under steady and pulsatile flow conditions. Supersonic SWE was used to acquire cine-loop data and quantify Young's modulus in cryogel vessel phantoms. Data were acquired by two observers, each performing three repeat measurements. Mean Young's modulus was quantified within 2-mm regions of interest averaged across five frames and, depending on vessel model and observer, ranged from 28 to 240 kPa. The mean inter-frame coefficient of variation (CV) was 0.13 (range: 0.07-0.18) for observer 1 and 0.14 (range: 0.12-0.16) for observer 2, with mean intra-class correlation coefficients (ICCs) of 0.84 and 0.83, respectively. The mean inter-operator CV was 0.13 (range: 0.08-0.20), with a mean ICC of 0.76 (range: 0.69-0.82). Our findings indicate that SWE can quantify Young's modulus of carotid plaque phantoms with good reproducibility, even in the presence of pulsatile flow.
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Affiliation(s)
- Kumar V Ramnarine
- Department of Medical Physics, University of Leicester NHS Trust, Leicester, United Kingdom.
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