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Ghigo N, Ramos-Palacios G, Bourquin C, Xing P, Wu A, Cortés N, Ladret H, Ikan L, Casanova C, Porée J, Sadikot A, Provost J. Dynamic Ultrasound Localization Microscopy Without ECG-Gating. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1436-1448. [PMID: 38969526 DOI: 10.1016/j.ultrasmedbio.2024.05.023] [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: 11/07/2023] [Revised: 05/04/2024] [Accepted: 05/22/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE Dynamic Ultrasound Localization Microscopy (DULM) has first been developed for non-invasive Pulsatility measurements in the rodent brain. DULM relies on the localization and tracking of microbubbles (MBs) injected into the bloodstream, to obtain highly resolved velocity and density cine-loops. Previous DULM techniques required ECG-gating, limiting its application to specific datasets, and increasing acquisition time. The objective of this study is to eliminate the need for ECG-gating in DULM experiments by introducing a motion-matching method for time registration. METHODS We developed a motion-matching algorithm based on tissue Doppler that leverages the cyclic tissue motion within the brain. Tissue Doppler was estimated for each group of frames in the acquisitions, at multiple locations identified as local maxima in the skin above the skull. Subsequently, each group of frames was time-registered to a reference group by delaying it based on the maximum correlation value between their respective tissue Doppler signals. This synchronization ensured that each group of frames aligned with the brain tissue motion of the reference group, and consequently, with its cardiac cycle. As a result, velocities of MBs could be averaged to retrieve flow velocity variations over time. RESULTS Initially validated in ECG-gated acquisitions in a rat model (n = 1), the proposed method was successfully applied in a mice model in 2D (n = 3) and in a feline model in 3D (n = 1). Performing time-registration with the proposed motion-matching method or by using ECG-gating leads to similar results. For the first time, dynamic velocity and density cine-loops were extracted without the need for any information on the animal ECG, and complex dynamic markers such as the Pulsatility index were estimated. CONCLUSION Results suggest that DULM can be performed without external gating, enabling the use of DULM on any ULM dataset where enough MBs are detectable. Time registration by motion-matching represents a significant advancement in DULM techniques, making DULM more accessible by simplifying its experimental complexity.
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Affiliation(s)
- Nin Ghigo
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada.
| | | | - Chloé Bourquin
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada
| | - Paul Xing
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada
| | - Alice Wu
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada
| | - Nelson Cortés
- School of Optometry, University of Montreal, Montréal, Quebec, Canada
| | - Hugo Ladret
- School of Optometry, University of Montreal, Montréal, Quebec, Canada; Institut de Neurosciences de la Timone, UMR 7289, CNRS and Aix-Marseille Université, Marseille, France
| | - Lamyae Ikan
- School of Optometry, University of Montreal, Montréal, Quebec, Canada
| | | | - Jonathan Porée
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada
| | - Abbas Sadikot
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
| | - Jean Provost
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada; Montreal Heart Institute, Montréal, Quebec, Canada
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Zhao Y, Zhang J, Yu H, Hou X, Zhang J. Noninvasive microvascular imaging in newborn rats using high-frequency ultrafast ultrasound. Neuroimage 2024; 297:120738. [PMID: 39009248 DOI: 10.1016/j.neuroimage.2024.120738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024] Open
Abstract
Ultrasound imaging stands as the predominant modality for neonatal health assessment, with recent advancements in ultrafast Doppler (μDoppler) technology offering significant promise in fields such as neonatal brain imaging. Combining μDoppler with high-frequency ultrasound (HF-μDoppler) presents a potential efficient avenue to enhance in vivo microvascular imaging in small animals, notably newborn rats, a crucial preclinical animal model for neonatal disease and development research. It is necessary to verify the imaging performance of HF-μDoppler in preclinical trials. This study investigates the microvascular imaging capabilities of HF-μDoppler using a 30 MHz high-frequency linear array probe in newborn rats. Results demonstrate the clarity of cerebral microvascular imaging in rats aged 1 to 7 postnatal days, extending to whole-body microvascular imaging, encompassing the central nervous system, including the brain and spinal cord. In conclusion, HF-μDoppler technology emerges as a reliable imaging tool, offering a new perspective for preclinical investigations into neonatal diseases and development.
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Affiliation(s)
- Yunlong Zhao
- Department of Pediatrics, Peking University First Hospital, Beijing, China; Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jiabin Zhang
- College of Future Technology, Peking University, Beijing, China.
| | - Hao Yu
- College of Engineering, Peking University, Beijing, China
| | - Xinlin Hou
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; College of Engineering, Peking University, Beijing, China
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Lai KL, Tsai MC, Li PC. Ultrafast Doppler Imaging for Early Detection of Synovitis in Rheumatoid Arthritis. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:484-493. [PMID: 38242743 DOI: 10.1016/j.ultrasmedbio.2023.12.007] [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: 09/20/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVE Current medical ultrasound systems possess limited sensitivity in detecting slow and weak blood flow during the early stages of rheumatoid arthritis (RA), leading to potential misdiagnosis. Ultrafast Doppler is capable of detecting slow and weak flow. This study was aimed at evaluating the diagnostic value of ultrafast Doppler for RA. METHODS Thirty-three RA patients (19 established, 14 early stage) and 15 healthy participants were enrolled. A programmable imaging platform with ultrafast Doppler capability was used. The benchmark was a clinical system with conventional Doppler imaging. Standardized dorsal long-axis scanning of both wrists was performed. Both ultrafast and conventional power Doppler (PD) images were quantitatively analyzed with computer assistance and semiquantitatively scored with the Outcome Measures in Rheumatology (OMERACT) scoring system. RESULTS Ultrafast PD revealed more blood area than conventional PD in both RA wrists and healthy wrists. Ultrafast PD OMERACT was positive in 65 of 66 RA wrists and 26 of 30 healthy wrists (sensitivity [SEN] = 0.985, accuracy [ACC] = 0.719), while conventional PD OMERACT was positive in 28 of 66 RA wrists and 0 of 30 healthy wrists (SEN = 0.424, ACC = 0.604). Ultrafast PD revealed a higher synovial PD area, dilated vessels and PD brightness in RA wrists. Peak synovial PD brightness had the best diagnostic value for RA (area under the receiver operating characteristic curve = 0.802, SEN = 0.909, ACC = 0.813). For early-stage RA patients, ultrafast peak synovial PD brightness had higher sensitivity and accuracy than conventional PD indexes. CONCLUSION Ultrafast PD had an increase of 0.561 in sensitivity and 0.209 in accuracy when compared with conventional PD. With its high sensitivity, ultrafast PD can detect early synovitis and identify RA patients during the early phase.
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Affiliation(s)
- Kuo-Lung Lai
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Min-Chieh Tsai
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Pai-Chi Li
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
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Kortenbout AJ, Costerus S, Dudink J, de Jong N, de Graaff JC, Vos HJ, Bosch JG. Automatic Max-Likelihood Envelope Detection Algorithm for Quantitative High-Frame-Rate Ultrasound for Neonatal Brain Monitoring. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:434-444. [PMID: 38143187 DOI: 10.1016/j.ultrasmedbio.2023.12.006] [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: 06/14/2023] [Revised: 11/07/2023] [Accepted: 12/03/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE Post-operative brain injury in neonates may result from disturbed cerebral perfusion, but accurate peri-operative monitoring is lacking. High-frame-rate (HFR) cerebral ultrasound could visualize and quantify flow in all detectable vessels using spectral Doppler; however, automated quantification in small vessels is challenging because of low signal amplitude. We have developed an automatic envelope detection algorithm for HFR pulsed wave spectral Doppler signals, enabling neonatal brain quantitative parameter maps during and after surgery. METHODS HFR ultrasound data from high-risk neonatal surgeries were recorded with a custom HFR mode (frame rate = 1000 Hz) on a Zonare ZS3 system. A pulsed wave Doppler spectrogram was calculated for each pixel containing blood flow in the image, and spectral peak velocity was tracked using a max-likelihood estimation algorithm of signal and noise regions in the spectrogram, where the most likely cross-over point marks the blood flow velocity. The resulting peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistivity index (RI) were compared with other detection schemes, manual tracking and RIs from regular pulsed wave Doppler measurements in 10 neonates. RESULTS Envelope detection was successful in both high- and low-quality arterial and venous flow spectrograms. Our technique had the lowest root mean square error for EDV, PSV and RI (0.46 cm/s, 0.53 cm/s and 0.15, respectively) when compared with manual tracking. There was good agreement between the clinical pulsed wave Doppler RI and HFR measurement with a mean difference of 0.07. CONCLUSION The max-likelihood algorithm is a promising approach to accurate, automated cerebral blood flow monitoring with HFR imaging in neonates.
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Affiliation(s)
- Anna J Kortenbout
- Biomedical Engineering, Department of Cardiology, University Medical Center Rotterdam, Erasmus MC, Rotterdam, The Netherlands
| | - Sophie Costerus
- Department of Pediatric Surgery, University Medical Center Rotterdam, Erasmus MC, Rotterdam, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nico de Jong
- Biomedical Engineering, Department of Cardiology, University Medical Center Rotterdam, Erasmus MC, Rotterdam, The Netherlands; Department of Imaging Physics, Medical Imaging, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Jurgen C de Graaff
- Department of Anesthesiology, University Medical Center Rotterdam, Erasmus MC, Rotterdam, The Netherlands; Department of Anesthesiology, Erasmus MC, Goes, The Netherlands; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Hendrik J Vos
- Biomedical Engineering, Department of Cardiology, University Medical Center Rotterdam, Erasmus MC, Rotterdam, The Netherlands; Department of Imaging Physics, Medical Imaging, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Johan G Bosch
- Biomedical Engineering, Department of Cardiology, University Medical Center Rotterdam, Erasmus MC, Rotterdam, The Netherlands.
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Faure F, Baranger J, Alison M, Boutillier B, Frérot A, Lim C, Planchette G, Prigent M, Tanter M, Baud O, Biran V, Demené C. Quantification of brain-wide vascular resistivity via ultrafast Doppler in human neonates helps early detection of white matter injury. J Cereb Blood Flow Metab 2024:271678X241232197. [PMID: 38340789 DOI: 10.1177/0271678x241232197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Preterm birth is associated with cerebrovascular development disruption and can induce white matter injuries (WMI). Transfontanellar ultrasound Doppler is the most widely used clinical imaging technique to monitor neonatal cerebral vascularisation and haemodynamics based on vascular indexes such as the resistivity index (RI); however, it has poor predictive value for brain damage. Indeed, these RI measurements are currently limited to large vessels, leading to a very limited probing of the brain's vascularisation, which may hinder prognosis. Here we show that ultrafast Doppler imaging (UfD) enables simultaneous quantification, in the whole field of view, of the local RI and vessel diameter, even in small vessels. Combining both pieces of information, we defined two new comprehensive resistivity parameters of the vascular trees. First, we showed that our technique is more sensitive in the early characterisation of the RI modifications between term and preterm neonates and for the first time we could show that the RI depends both on the vessel diameter and vascular territory. We then showed that our parameters can be used for early prediction of WMI. Our results demonstrate the potential of UfD to provide new biomarkers and pave the way for continuous monitoring of neonatal brain resistivity.
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Affiliation(s)
- Flora Faure
- Physics for Medicine, INSERM U1273, CNRS, ESPCI, PSL Research University, Paris, France
| | - Jérôme Baranger
- Physics for Medicine, INSERM U1273, CNRS, ESPCI, PSL Research University, Paris, France
| | - Marianne Alison
- Department of Radiology, Assistance Publique-Hôpitaux de Paris, Robert Debré Children's Hospital, University Paris Cité, Paris, France
| | - Béatrice Boutillier
- Neonatal Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Robert Debré Children's Hospital, University Paris Cité, Paris, France
| | - Alice Frérot
- Neonatal Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Robert Debré Children's Hospital, University Paris Cité, Paris, France
| | - Chung Lim
- Department of Radiology, Assistance Publique-Hôpitaux de Paris, Robert Debré Children's Hospital, University Paris Cité, Paris, France
| | - Grégory Planchette
- Department of Radiology, Assistance Publique-Hôpitaux de Paris, Robert Debré Children's Hospital, University Paris Cité, Paris, France
| | - Mickael Prigent
- Department of Radiology, Assistance Publique-Hôpitaux de Paris, Robert Debré Children's Hospital, University Paris Cité, Paris, France
| | - Mickaël Tanter
- Physics for Medicine, INSERM U1273, CNRS, ESPCI, PSL Research University, Paris, France
| | - Olivier Baud
- Department of Pediatric, University Hospital of Geneva, University of Geneva, Geneva, Switzerland. O.B. is also with INSERM U1141, Robert Debré Children's Hospital, University Paris Cité, Paris, France
| | - Valérie Biran
- Neonatal Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Robert Debré Children's Hospital, University Paris Cité, Paris, France
- I2D2, INSERM U1141, University Paris Cité Paris, France
| | - Charlie Demené
- Physics for Medicine, INSERM U1273, CNRS, ESPCI, PSL Research University, Paris, France
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Rondagh M, Kortenbout AJ, de Munck S, van den Bosch GE, Dudink J, Vos HJ, Bosch JG, de Graaff JC. A comparison of ultrafast and conventional spectral Doppler ultrasound to measure cerebral blood flow velocity during inguinal hernia repair in infants. J Clin Anesth 2024; 92:111312. [PMID: 37926064 DOI: 10.1016/j.jclinane.2023.111312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/13/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Ultrafast cerebral Doppler ultrasound enables simultaneous quantification and visualization of cerebral blood flow velocity. The aim of this study is to compare the use of conventional and ultrafast spectral Doppler during anesthesia and their potential to show the effect of anesthesiologic procedures on cerebral blood flow velocities, in relation to blood pressure and cerebral oxygenation in infants undergoing inguinal hernia repair. METHODS A single-center prospective observational cohort study in infants up to six months of age. We evaluated conventional and ultrafast spectral Doppler cerebral ultrasound measurements in terms of number of successful measurements during the induction of anesthesia, after sevoflurane induction, administration of caudal analgesia, a fluid bolus and emergence of anesthesia. Cerebral blood flow velocity was quantified in pial arteries using conventional spectral Doppler and in the cerebral cortex using ultrafast Doppler by peak systolic velocity, end diastolic velocity and resistivity index. RESULTS Twenty infants were included with useable conventional spectral Doppler images in 72/100 measurements and ultrafast Doppler images in 51/100 measurements. Intraoperatively, the success rates were 53/60 (88.3%) and 41/60 (68.3%), respectively. Cerebral blood flow velocity increased after emergence for both conventional (end diastolic velocity, from 2.01 to 2.75 cm/s, p < 0.001) and ultrafast spectral Doppler (end diastolic velocity, from 0.59 to 0.94 cm/s), whereas cerebral oxygenation showed a reverse pattern with a decrease after the emergence of the infant (85% to 68%, p < 0.001). CONCLUSION It is possible to quantify cortical blood flow velocity during general anesthesia using conventional and ultrafast spectral Doppler cerebral ultrasound. Cerebral blood flow velocity and blood pressure decreased, while regional cerebral oxygenation increased during general anesthesia. Ultrafast spectral Doppler ultrasound offers novel insights into perfusion within the cerebral cortex, unattainable through conventional spectral ultrasound. Yet, ultrafast Doppler is curtailed by a lower success rate and a more rigorous learning curve compared to conventional method.
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Affiliation(s)
- Mathies Rondagh
- Department of Anesthesiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Anna J Kortenbout
- Department of Biomedical Engineering, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Sophie de Munck
- Department of Surgery, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Gerbrich E van den Bosch
- Department of Neonatology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Jeroen Dudink
- Department of Neonatology, UMC Utrecht University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Hendrik J Vos
- Department of Biomedical Engineering, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Johan G Bosch
- Department of Biomedical Engineering, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Jurgen C de Graaff
- Department of Anesthesiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands; Department of Anesthesiology, Adrz - Erasmus MC, Goes, the Netherlands; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States of America.
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Oh D, Lee D, Heo J, Kweon J, Yong U, Jang J, Ahn YJ, Kim C. Contrast Agent-Free 3D Renal Ultrafast Doppler Imaging Reveals Vascular Dysfunction in Acute and Diabetic Kidney Diseases. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303966. [PMID: 37847902 PMCID: PMC10754092 DOI: 10.1002/advs.202303966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/19/2023] [Indexed: 10/19/2023]
Abstract
To combat the irreversible decline in renal function associated with kidney disease, it is essential to establish non-invasive biomarkers for assessing renal microcirculation. However, the limited resolution and/or vascular sensitivity of existing diagnostic imaging techniques hinders the visualization of complex cortical vessels. Here, a 3D renal ultrafast Doppler (UFD) imaging system that uses a high ultrasound frequency (18 MHz) and ultrahigh frame rate (1 KHz per slice) to scan the entire volume of a rat's kidney in vivo is demonstrated. The system, which can visualize the full 3D renal vascular branching pyramid at a resolution of 167 µm without any contrast agent, is used to chronically and noninvasively monitor kidneys with acute kidney injury (AKI, 3 days) and diabetic kidney disease (DKD, 8 weeks). Multiparametric UFD analyses (e.g., vessel volume occupancy (VVO), fractional moving blood volume (FMBV), vessel number density (VND), and vessel tortuosity (VT)) describe rapid vascular rarefaction from AKI and long-term vascular degeneration from DKD, while the renal pathogeneses are validated by in vitro blood serum testing and stained histopathology. This work demonstrates the potential of 3D renal UFD to offer valuable insights into assessing kidney perfusion levels for future research in diabetes and kidney transplantation.
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Affiliation(s)
- Donghyeon Oh
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Donghyun Lee
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jinseok Heo
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jooyoung Kweon
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Uijung Yong
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jinah Jang
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Yong Joo Ahn
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Chulhong Kim
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
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Jing B, Carrasco DI, AuYong N, Lindsey BD. A Transverse Velocity Spectral Estimation Method for Ultrafast Ultrasound Doppler Imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1749-1760. [PMID: 37721880 PMCID: PMC10762297 DOI: 10.1109/tuffc.2023.3316748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
A novel transverse velocity spectral estimation method is proposed to estimate the velocity component in the direction transverse to the beam axis for ultrafast imaging. The transverse oscillation was introduced by filtering the envelope data after the axial oscillation was removed. The complex transverse oscillated signal was then used to estimate the transverse velocity spectrum and mean velocity. In simulations, both steady flow with a parabolic flow profile and temporally varying flow were simulated to investigate the performance of the proposed method. Next, the proposed approach was used to estimate the flow velocity in a phantom with pulsatile flow, and finally, this method was applied in vivo in a small animal model. Results of the simulation study indicate that the proposed method provided an accurate velocity spectrogram for beam-to-flow angles from 45° to 90°, without significant performance degradation as the angle decreased. For the simulation of temporally varying flow, the proposed method had a reduced bias ( % versus 73.3%) and higher peak-to-background ratio (PBR) (>15.6 versus 10.5 dB) compared to previous methods. Results in a vessel phantom show that the temporally varying flow velocity can be estimated in the transverse direction obtained using the spectrogram produced by the proposed method operating on the envelope data. Finally, the proposed method was used to map the microvascular blood flow velocity in the mouse spinal cord, demonstrating the estimation of pulsatile blood flow in both the axial and transverse directions in vivo over several cardiac cycles.
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Zaed I, Della Pepa GM, Cannizzaro D, Menna G, Cardia A. Applicability and efficacy of ultrasound elastography in neurosurgery: a systematic review of the literature. J Neurosurg Sci 2023; 67:750-757. [PMID: 36239425 DOI: 10.23736/s0390-5616.22.05866-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Neurosurgery is one of the fields in which intraoperative imaging is paramount. One of these main imaging tools that have been acquiring the interest of the neurosurgical community is Ultrasound elastography (USE), which is an imaging technology sensitive to tissue stiffness. Here we present a systematic review of the use of USE in neurosurgery. EVIDENCE ACQUISITION A systematic review of the literature has been performed, according to the PRISMA guideline, for the last 30 years on 3 different databases (MEDLINE, Scopus, and Cochrane), to gather all the studies on the use of ultrasound elastography for neurosurgical pathologies, including both clinical and laboratory studies. EVIDENCE SYNTHESIS A total of 15 articles met the inclusion criteria. USE has widely and safely been used especially for oncological lesions (meningiomas and gliomas) and focal cortical dysplasia. However, there are also encouraging laboratory studies about its application for the management of traumatic brain injury, and ischemic stroke. CONCLUSIONS This systematic review showed that, despite the lack of strong evidence, USE is a valid intraoperative tool, especially in oncological neurosurgery.
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Affiliation(s)
- Ismail Zaed
- Department of Neurosurgery, ASST Ovest Milanese, Legnano Hospital, Milan, Italy -
| | - Giuseppe M Della Pepa
- Institute of Neurosurgery, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Delia Cannizzaro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Neurosurgery, IRCCS Humanitas Clinic, Rozzano, Milan, Italy
| | - Grazia Menna
- Institute of Neurosurgery, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Andrea Cardia
- Department of Neurosurgery, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
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Yang J, Cherin E, Yin J, Dayton PA, Foster FS, Demore CEM. Superharmonic and Microultrasound Imaging With Plane Wave Beamforming Techniques. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1442-1456. [PMID: 37713228 PMCID: PMC10712286 DOI: 10.1109/tuffc.2023.3316120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Superharmonic contrast imaging (SpHI) suppresses tissue clutter and allows high-contrast visualization of the vasculature. An array-based dual-frequency (DF) probe has been developed for SpHI, integrating a 21-MHz, 256-element microultrasound imaging array with a 2-MHz, 32-element array to take advantage of the broadband nonlinear responses from microbubble (MB) contrast agents. In this work, ultrafast imaging with plane waves was implemented for SpHI to increase the acquisition frame rate. Ultrafast imaging was also implemented for microultrasound B-mode imaging (HFPW B-mode) to enable high-resolution visualization of the tissue structure. Coherent compounding was demonstrated in vitro and in vivo in both imaging modes. Acquisition frame rates of 4.5 kHz and 187 Hz in HFPW B-mode imaging were achieved for imaging up to 21 mm with one and 25 angles, respectively, and 3.5 kHz and 396 Hz in the SpHI mode with one and nine coherently compounded angles, respectively. SpHI images showed suppression of tissue clutter prior to and after the introduction of MBs in vitro and in vivo. The nine-angle coherently compounded 2-D SpHI images of contrast-filled flow channel showed a contrast-to-tissue ratio (CTR) of 26.0 dB, a 2.5-dB improvement relative to images reconstructed from 0° steering. Consistent with in vitro imaging, the nine-angle compounded 2-D SpHI of a Lewis lung cancer tumor showed a 2.6-dB improvement in contrast enhancement, relative to 0° steering, and additionally revealed a region of nonviable tissue. The 3-D display of the volumetric SpHI data acquired from a xenograft mouse tumor using both 0° steering and nine-angle compounding allowed the visualization of the tumor vasculature. A small vessel visible in the compounded SpHI image, measuring around [Formula: see text], is not visualized in the 0° steering SpHI image, demonstrating the superiority of the latter in detecting fine structures within the tumor.
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Apeksha Reddy P, Sreenivasulu H, Shokrolahi M, Muppalla SK, Abdilov N, Ramar R, Halappa Nagaraj R, Vuppalapati S. Navigating the Complexities of Intraventricular Hemorrhage in Preterm Infants: An Updated Review. Cureus 2023; 15:e38985. [PMID: 37323305 PMCID: PMC10261871 DOI: 10.7759/cureus.38985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 06/17/2023] Open
Abstract
Intraventricular hemorrhage (IVH) is a type of bleeding that occurs in the ventricular cavity of the brain. In this comprehensive study, we provide a summary of the pathogenesis, diagnosis, and treatment of intraventricular hemorrhage in premature infants. Preterm babies are at high risk of developing IVH because their germinal matrix is not fully developed, making their blood vessels more prone to rupture. However, that is not necessarily the case in all preterm babies as the inherent structure of the germinal matrix makes it more susceptible to hemorrhage. Incidences of IVH are discussed based on recent data which states that around 12,000 premature infants in the United States experience IVH each year. Although grades I and II make up the majority of IVH cases and are frequently asymptomatic, IVH remains a significant issue for premature infants in neonatal intensive care facilities worldwide. Grades I and II have been linked to mutations in the type IV procollagen gene, COL4A1, as well as prothrombin G20210A and factor V Leiden mutations. Intraventricular hemorrhage can be detected using brain imaging in the first seven to 14 days following delivery. This review also shines a light on reliable methods for identifying IVH in premature newborns like cranial ultrasound and magnetic resonance imaging along with the treatment of IVH which is primarily supportive and involves the management of intracranial pressure, the correction of coagulation abnormalities, and the prevention of seizures.
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Affiliation(s)
| | | | | | | | - Nurlan Abdilov
- Internal Medicine, University of Debrecen, Debrecen, HUN
| | - Rajasekar Ramar
- Internal Medicine, Rajah Muthiah Medical College and Hospital, Chidambaram, IND
| | | | - Sravya Vuppalapati
- Pediatrics, P.E.S. Institute of Medical Sciences and Research, Kuppam, IND
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12
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Jarmund AH, Pedersen SA, Torp H, Dudink J, Nyrnes SA. A Scoping Review of Cerebral Doppler Arterial Waveforms in Infants. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:919-936. [PMID: 36732150 DOI: 10.1016/j.ultrasmedbio.2022.12.007] [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: 09/14/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 06/18/2023]
Abstract
Cerebral Doppler ultrasound has been an important tool in pediatric diagnostics and prognostics for decades. Although the Doppler spectrum can provide detailed information on cerebral perfusion, the measured spectrum is often reduced to simple numerical parameters. To help pediatric clinicians recognize the visual characteristics of disease-associated Doppler spectra and identify possible areas for future research, a scoping review of primary studies on cerebral Doppler arterial waveforms in infants was performed. A systematic search in three online bibliographic databases yielded 4898 unique records. Among these, 179 studies included cerebral Doppler spectra for at least five infants below 1 y of age. The studies describe variations in the cerebral waveforms related to physiological changes (43%), pathology (62%) and medical interventions (40%). Characteristics were typically reported as resistance index (64%), peak systolic velocity (43%) or end-diastolic velocity (39%). Most studies focused on the anterior (59%) and middle (42%) cerebral arteries. Our review highlights the need for a more standardized terminology to describe cerebral velocity waveforms and for precise definitions of Doppler parameters. We provide a list of reporting variables that may facilitate unambiguous reports. Future studies may gain from combining multiple Doppler parameters to use more of the information encoded in the Doppler spectrum, investigating the full spectrum itself and using the possibilities for long-term monitoring with Doppler ultrasound.
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Affiliation(s)
- Anders Hagen Jarmund
- Department of Circulation and Medical Imaging (ISB), NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
| | - Sindre Andre Pedersen
- Library Section for Research Support, Data and Analysis, NTNU University Library, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans Torp
- Department of Circulation and Medical Imaging (ISB), NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Siri Ann Nyrnes
- Department of Circulation and Medical Imaging (ISB), NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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13
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Xiao T, Dong X, Lu Y, Zhou W. High-Resolution and Multidimensional Phenotypes Can Complement Genomics Data to Diagnose Diseases in the Neonatal Population. PHENOMICS (CHAM, SWITZERLAND) 2023; 3:204-215. [PMID: 37197647 PMCID: PMC10110825 DOI: 10.1007/s43657-022-00071-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 05/19/2023]
Abstract
Advances in genomic medicine have greatly improved our understanding of human diseases. However, phenome is not well understood. High-resolution and multidimensional phenotypes have shed light on the mechanisms underlying neonatal diseases in greater details and have the potential to optimize clinical strategies. In this review, we first highlight the value of analyzing traditional phenotypes using a data science approach in the neonatal population. We then discuss recent research on high-resolution, multidimensional, and structured phenotypes in neonatal critical diseases. Finally, we briefly introduce current technologies available for the analysis of multidimensional data and the value that can be provided by integrating these data into clinical practice. In summary, a time series of multidimensional phenome can improve our understanding of disease mechanisms and diagnostic decision-making, stratify patients, and provide clinicians with optimized strategies for therapeutic intervention; however, the available technologies for collecting multidimensional data and the best platform for connecting multiple modalities should be considered.
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Affiliation(s)
- Tiantian Xiao
- Division of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, 399 Wanyuan Road, Shanghai, 201102 China
- Department of Neonatology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610000 China
| | - Xinran Dong
- Center for Molecular Medicine, Pediatric Research Institute, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102 China
| | - Yulan Lu
- Center for Molecular Medicine, Pediatric Research Institute, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102 China
| | - Wenhao Zhou
- Division of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, 399 Wanyuan Road, Shanghai, 201102 China
- Center for Molecular Medicine, Pediatric Research Institute, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102 China
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14
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Aguet J, Fakhari N, Nguyen M, Mertens L, Szabo E, Ertl-Wagner B, Crawford L, Haller C, Barron D, Baranger J, Villemain O. Impact of cardiopulmonary bypass on cerebrovascular autoregulation assessed by ultrafast ultrasound imaging. J Physiol 2023; 601:1077-1093. [PMID: 36779673 DOI: 10.1113/jp284070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/03/2023] [Indexed: 02/14/2023] Open
Abstract
Newborns with congenital heart disease undergoing cardiac surgery are at risk of neurodevelopmental impairment with limited understanding of the impact of intra-operative cardiopulmonary bypass (CPB), deep hypothermia and selective cerebral perfusion on the brain. We hypothesized that a novel ultrasound technique, ultrafast power Doppler (UPD), can assess variations of cerebral blood volume (CBV) in neonates undergoing cardiac surgery requiring CPB. UPD was performed before, during and after surgery in newborns with hypoplastic left heart syndrome undergoing a Norwood operation. We found that global CBV was not significantly different between patients and controls (P = 0.98) and between pre- and post-surgery (P = 0.62). UPD was able to monitor changes in CBV throughout surgery, revealing regional differences in CBV during hypothermia during which CBV correlated with CPB flow rate (R2 = 0.52, P = 0.021). Brain injury on post-operative magnetic resonance imaging was observed in patients with higher maximum variation in CBV. Our findings suggest that UPD can quantify global and regional brain perfusion variation during neonatal cardiac surgery with this first intra-operative application demonstrating an association between CBV and CPB flow rate, suggesting loss of autoregulation. Therefore, the measurement of CBV by UPD could enable optimization of cerebral perfusion during cardiac surgery in neonates. KEY POINTS: The impact of cardiopulmonary bypass (CPB) on the neonatal brain undergoing cardiac surgery is poorly understood. Ultrafast power Doppler (UPD) quantifies cerebral blood volume (CBV), a surrogate of brain perfusion. CBV varies throughout CPB surgery and is associated with variation of the bypass pump flow rate during deep hypothermia. Association between CBV and bypass pump flow rate suggests loss of cerebrovascular autoregulatory processes. Quantitative monitoring of cerebral perfusion by UPD could provide a direct parameter to optimize CPB flow rate.
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Affiliation(s)
- Julien Aguet
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Nikan Fakhari
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Minh Nguyen
- Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Luc Mertens
- Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Elod Szabo
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Birgit Ertl-Wagner
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Lynn Crawford
- Department of Surgery, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christoph Haller
- Department of Surgery, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - David Barron
- Department of Surgery, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jérôme Baranger
- Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Olivier Villemain
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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15
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Jakovljevic M, Michaelides R, Biondi E, Hyun D, Zebker HA, Dahl JJ. Adaptation of Range-Doppler Algorithm for Efficient Beamforming of Monostatic and Multistatic Ultrasound Signals. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:3165-3178. [PMID: 36094975 PMCID: PMC9815947 DOI: 10.1109/tuffc.2022.3205923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Algorithmic changes that increase beamforming speed have become increasingly relevant to processing synthetic aperture (SA) ultrasound data. In particular, beamforming SA data in a spatio-temporal frequency domain using the F-k (Stolt) migration have been shown to reduce the beamforming time by up to two orders of magnitude compared with the conventional delay-and-sum (DAS) beamforming, and it has been used in applications where large amounts of raw data make real-time frame rates difficult to attain, such as multistatic SA imaging and plane-wave Doppler imaging with large ensemble lengths. However, beamforming signals in a spatio-temporal Fourier space can require loading large blocks of data at once, making it memory-intensive and less suited for parallel (i.e., multithreaded) processing. As an alternative, we propose beamforming in a range-Doppler (RD) frequency domain using the range-Doppler algorithm (RDA) that has originally been developed for SA radar (SAR) imaging. Through simulation and phantom experiments, we show that RDA achieves similar lateral resolution and contrast compared with DAS and F-k migration. At the same time, higher axial sidelobes in RDA images can be reduced via (temporal) frequency binning. Like the F-k migration, RDA significantly reduces the overall number of computations relative to DAS, and it achieves ten times lower processing time on a single CPU. Because RDA uses only a spatial Fourier transform (FT), it requires two times less memory than the F-k migration to process the simulated multistatic data and can be executed on as many as a thousand parallel threads (compared with eight parallel threads for the F-k migration), making it more suitable for implementation on modern graphics processing units (GPUs). While RDA is not as parallelizable as DAS, it is expected to hold a significant speed advantage on devices with moderate parallel processing capabilities (up to several thousand cores), such as point-of-care and low-cost ultrasound devices.
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16
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Bourquin C, Poree J, Lesage F, Provost J. In Vivo Pulsatility Measurement of Cerebral Microcirculation in Rodents Using Dynamic Ultrasound Localization Microscopy. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:782-792. [PMID: 34710041 DOI: 10.1109/tmi.2021.3123912] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
An increased pulse pressure, due to arteries stiffening with age and cardiovascular disease, may lead to downstream brain damage in microvessels and cognitive decline. Brain-wide imaging of the pulsatility propagation from main feeding arteries to capillaries in small animals could improve our understanding of the link between pulsatility and cognitive decline. However, it requires higher spatiotemporal resolution and penetration depth than currently available with existing brain imaging techniques. Herein, we show the feasibility of performing Dynamic Ultrasound Localization Microscopy (DULM), a novel imaging approach to capture hemodynamics with a subwavelength resolution. By producing cine-loops of flowing microbubbles in 2D in the whole rodent brain lasting several cardiac cycles, DULM performed pulsatility measurements in microvessels in-depth, in vivo, with and without craniotomy. Cortical veins and arteries were shown to have a significatively different pulsatility index and the method was compared against Contrast Enhanced Ultrafast Ultrasound Doppler (CEUFD) pulsatility measurements.
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17
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Li YL, Hyun D, Ducey-Wysling J, Durot I, D'Hondt A, Patel BN, Dahl JJ. Real-Time In Vivo Imaging of Human Liver Vasculature Using Coherent Flow Power Doppler: A Pilot Clinical Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:3027-3041. [PMID: 34003748 PMCID: PMC8515835 DOI: 10.1109/tuffc.2021.3081438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Power Doppler (PD) is a commonly used technique for flow detection and vessel visualization in radiology clinics. Despite its broad set of applications, PD suffers from multiple noise sources and artifacts, such as thermal noise, clutter, and flash artifacts. In addition, a tradeoff exists between acquisition time and Doppler image quality. These limit the ability of clinical PD imaging in deep-lying and small-vessel detection and visualization, particularly among patients with high body mass indices (BMIs). To improve the Doppler vessel detection, we have previously proposed coherent flow PD (CFPD) imaging and demonstrated its performance on porcine vasculature. In this article, we report on a pilot clinical study of CFPD imaging on healthy human volunteers and patients with high BMI to assess the clinical feasibility of the technique in liver imaging. In this study, we built a real-time CFPD imaging system using a graphical processing unit (GPU)-based software beamformer and a CFPD processing module. Using the real-time CFPD imaging system, the liver vasculature of 15 healthy volunteers with normal BMI below 25 and 15 patients with BMI greater than 25 was imaged. Both PD and CFPD image streams were produced simultaneously. The generalized contrast-to-noise ratio (gCNR) of the PD and CFPD images was measured to provide the quantitative evaluation of image quality and vessel detectability. Comparison of PD and CFPD image shows that gCNR is improved by 35% in healthy volunteers and 28% in high BMI patients with CFPD compared to PD. Example images are provided to show that the improvement in the Doppler image gCNR leads to greater detection of small vessels in the liver. In addition, we show that CFPD can suppress in vivo reverberation clutter in clinical imaging.
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18
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Baranger J, Villemain O, Wagner M, Vargas-Gutierrez M, Seed M, Baud O, Ertl-Wagner B, Aguet J. Brain perfusion imaging in neonates. NEUROIMAGE-CLINICAL 2021; 31:102756. [PMID: 34298475 PMCID: PMC8319803 DOI: 10.1016/j.nicl.2021.102756] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/21/2021] [Accepted: 07/03/2021] [Indexed: 02/07/2023]
Abstract
MRI is the modality of choice to image and quantify cerebral perfusion. Imaging of neonatal brain perfusion is possible using MRI and ultrasound. Novel ultrafast ultrasound imaging allows for excellent spatiotemporal resolution. Understanding cerebral hemodynamic changes of neonatal adaptation is key.
Abnormal variations of the neonatal brain perfusion can result in long-term neurodevelopmental consequences and cerebral perfusion imaging can play an important role in diagnostic and therapeutic decision-making. To identify at-risk situations, perfusion imaging of the neonatal brain must accurately evaluate both regional and global perfusion. To date, neonatal cerebral perfusion assessment remains challenging. The available modalities such as magnetic resonance imaging (MRI), ultrasound imaging, computed tomography (CT), near-infrared spectroscopy or nuclear imaging have multiple compromises and limitations. Several promising methods are being developed to achieve better diagnostic accuracy and higher robustness, in particular using advanced MRI and ultrasound techniques. The objective of this state-of-the-art review is to analyze the methodology and challenges of neonatal brain perfusion imaging, to describe the currently available modalities, and to outline future perspectives.
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Affiliation(s)
- Jérôme Baranger
- Department of Pediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Translation Medicine Department, SickKids Research Institute, Toronto, Ontario, Canada
| | - Olivier Villemain
- Department of Pediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Translation Medicine Department, SickKids Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Matthias Wagner
- Department of Diagnostic Imaging, Division of Neuroradiology, The Hospital for Sick Children, Toronto, Canada
| | | | - Mike Seed
- Department of Pediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Translation Medicine Department, SickKids Research Institute, Toronto, Ontario, Canada; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Olivier Baud
- Division of Neonatology and Pediatric Intensive Care, Children's University Hospital of Geneva and University of Geneva, Geneva, Switzerland
| | - Birgit Ertl-Wagner
- Department of Diagnostic Imaging, Division of Neuroradiology, The Hospital for Sick Children, Toronto, Canada
| | - Julien Aguet
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.
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19
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Nayak R, MacNeill J, Flores C, Webb J, Fatemi M, Alizad A. Quantitative assessment of ensemble coherency in contrast-free ultrasound microvasculature imaging. Med Phys 2021; 48:3540-3558. [PMID: 33942320 PMCID: PMC8362033 DOI: 10.1002/mp.14918] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 11/09/2022] Open
Abstract
Purpose Contrast‐free visualization of microvascular blood flow (MBF) using ultrasound can play a valuable role in diagnosis and detection of diseases. In this study, we demonstrate the importance of quantifying ensemble coherence for robust MBF imaging. We propose a novel approach to quantify ensemble coherence by estimating the local spatiotemporal correlation (LSTC) image, and evaluate its efficacy through simulation and in vivo studies. Methods The in vivo patient studies included three volunteers with a suspicious breast tumor, 15 volunteers with a suspicious thyroid tumor, and two healthy volunteers for renal MBF imaging. The breast data displayed negligible prior motion and were used for simulation analysis involving synthetically induced motion, to assess its impact on ensemble coherency and motion artifacts in MBF images. The in vivo thyroid data involved complex physiological motion due to its proximity to the pulsating carotid artery, which was used to assess the in vivo efficacy of the proposed technique. Further, in vivo renal MBF images demonstrated the feasibility of using the proposed ensemble coherence metric for curved array‐based MBF imaging involving phase conversion. All ultrasound data were acquired at high imaging frame rates and the tissue signal was suppressed using spatiotemporal clutter filtering. Thyroid tissue motion was estimated using two‐dimensional normalized cross correlation‐based speckle tracking, which was subsequently used for ensemble motion correction. The coherence of the MBF image was quantified based on Casorati correlation of the Doppler ensemble. Results The simulation results demonstrated that an increase in ensemble motion corresponded with a decrease in ensemble coherency, which reciprocally degraded the MBF images. Further the data acquired from breast tumors demonstrated higher ensemble coherency than that from thyroid tumors. Motion correction improved the coherence of the thyroid MBF images, which substantially improved its visualization. The proposed coherence metrics were also useful in assessing the ensemble coherence for renal MBF imaging. The results also demonstrated that the proposed coherence metric can be reliably estimated from downsampled ensembles (by up to 90%), thus allowing improved computational efficiency for potential applications in real‐time MBF imaging. Conclusions This pilot study demonstrates the importance of assessing ensemble coherency in contrast‐free MBF imaging. The proposed LSTC image quantified coherence of the Doppler ensemble for robust MBF imaging. The results obtained from this pilot study are promising, and warrant further development and in vivo validation.
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Affiliation(s)
- Rohit Nayak
- Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, 55902, USA
| | - Justin MacNeill
- Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, 55902, USA
| | - Cecilia Flores
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, 55902, USA
| | - Jeremy Webb
- Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, 55902, USA
| | - Mostafa Fatemi
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, 55902, USA
| | - Azra Alizad
- Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, 55902, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, 55902, USA
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20
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Tataranno ML, Vijlbrief DC, Dudink J, Benders MJNL. Precision Medicine in Neonates: A Tailored Approach to Neonatal Brain Injury. Front Pediatr 2021; 9:634092. [PMID: 34095022 PMCID: PMC8171663 DOI: 10.3389/fped.2021.634092] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/14/2021] [Indexed: 11/27/2022] Open
Abstract
Despite advances in neonatal care to prevent neonatal brain injury and neurodevelopmental impairment, predicting long-term outcome in neonates at risk for brain injury remains difficult. Early prognosis is currently based on cranial ultrasound (CUS), MRI, EEG, NIRS, and/or general movements assessed at specific ages, and predicting outcome in an individual (precision medicine) is not yet possible. New algorithms based on large databases and machine learning applied to clinical, neuromonitoring, and neuroimaging data and genetic analysis and assays measuring multiple biomarkers (omics) can fulfill the needs of modern neonatology. A synergy of all these techniques and the use of automatic quantitative analysis might give clinicians the possibility to provide patient-targeted decision-making for individualized diagnosis, therapy, and outcome prediction. This review will first focus on common neonatal neurological diseases, associated risk factors, and most common treatments. After that, we will discuss how precision medicine and machine learning (ML) approaches could change the future of prediction and prognosis in this field.
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Affiliation(s)
| | | | | | - Manon J. N. L. Benders
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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21
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Pereira SS, Sinha AK, Shah DK, Kempley ST. Common carotid artery blood flow volume in extremely preterm infants. Acta Paediatr 2021; 110:1157-1165. [PMID: 33145798 DOI: 10.1111/apa.15655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/14/2020] [Accepted: 11/02/2020] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to determine carotid blood flow volume, a surrogate for cerebral blood flow, using Doppler ultrasound in extremely preterm infants. METHODS In infants <29 weeks, right common carotid artery flow volume (RCCAF) was calculated from vessel diameter and intensity-weighted mean velocity measured using Doppler ultrasound on days 1 and 3. In addition, left ventricular output (LVO), ductus arteriosus characteristics and invasive mean arterial blood pressure (MABP) were obtained. RESULTS Sixty infants with mean gestation of 25.8 weeks were studied. The median RCCAF increased from 12 (IQR 9-15) mL/kg/min on day 1, to 14 (IQR 12-18) mL/kg/min on day 3 (p = 0.007). RCCAF was positively correlated with invasive MABP on days 1 and 3. RCCAF significantly correlated with LVO in infants with closing or closed ductus arteriosus on day 1. Using multiple regression analysis, RCCAF was significantly associated with invasive MABP on day 1 and to inotropic treatment on day 3. CONCLUSION Doppler ultrasound can be used to measure RCCAF in extremely preterm infants receiving intensive care. RCCAF increased during the first three days and was positively related to invasive MABP on day 1. Values were lower than previously described in more mature infants. CLINICAL TRIAL REGISTRATION ISRCTN 83507686.
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Affiliation(s)
- Sujith S. Pereira
- Centre for Genomics and Child Health Blizard Institute Barts and the London School of Medicine Queen Mary University of London London UK
- Neonatal Unit Homerton University Hospital Foundation NHS Trust London UK
| | - Ajay K. Sinha
- Centre for Genomics and Child Health Blizard Institute Barts and the London School of Medicine Queen Mary University of London London UK
- Neonatal Unit Royal London Hospital, Barts Health NHS Trust London UK
| | - Divyen K. Shah
- Neonatal Unit Royal London Hospital, Barts Health NHS Trust London UK
- Centre for Neuroscience and Trauma Blizard Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London London UK
| | - Stephen T. Kempley
- Centre for Genomics and Child Health Blizard Institute Barts and the London School of Medicine Queen Mary University of London London UK
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22
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Demené C, Robin J, Dizeux A, Heiles B, Pernot M, Tanter M, Perren F. Transcranial ultrafast ultrasound localization microscopy of brain vasculature in patients. Nat Biomed Eng 2021; 5:219-228. [PMID: 33723412 PMCID: PMC7610356 DOI: 10.1038/s41551-021-00697-x] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 02/05/2021] [Indexed: 12/23/2022]
Abstract
Changes in cerebral blood flow are associated with stroke, aneurysms, vascular cognitive impairment, neurodegenerative diseases and other pathologies. Brain angiograms, typically performed via computed tomography or magnetic resonance imaging, are limited to millimetre-scale resolution and are insensitive to blood-flow dynamics. Here we show that ultrafast ultrasound localization microscopy of intravenously injected microbubbles enables transcranial imaging of deep vasculature in the adult human brain at microscopic resolution and the quantification of haemodynamic parameters. Adaptive speckle tracking to correct for micrometric brain-motion artefacts and ultrasonic-wave aberrations induced during transcranial propagation allowed us to map the vascular network of tangled arteries to functionally characterize blood-flow dynamics at a resolution of up to 25 μm and to detect blood vortices in a small deep-seated aneurysm in a patient. Ultrafast ultrasound localization microscopy may facilitate the understanding of brain haemodynamics and of how vascular abnormalities in the brain are related to neurological pathologies.
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Affiliation(s)
- Charlie Demené
- Physics for Medicine Paris, Inserm, ESPCI Paris, PSL Research University, CNRS, Paris, France.,Department of Clinical Neurosciences, HUG, LUNIC Laboratory Geneva Neurocenter, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Justine Robin
- Physics for Medicine Paris, Inserm, ESPCI Paris, PSL Research University, CNRS, Paris, France.,Department of Clinical Neurosciences, HUG, LUNIC Laboratory Geneva Neurocenter, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexandre Dizeux
- Physics for Medicine Paris, Inserm, ESPCI Paris, PSL Research University, CNRS, Paris, France
| | - Baptiste Heiles
- Physics for Medicine Paris, Inserm, ESPCI Paris, PSL Research University, CNRS, Paris, France
| | - Mathieu Pernot
- Physics for Medicine Paris, Inserm, ESPCI Paris, PSL Research University, CNRS, Paris, France
| | - Mickael Tanter
- Physics for Medicine Paris, Inserm, ESPCI Paris, PSL Research University, CNRS, Paris, France.
| | - Fabienne Perren
- Department of Clinical Neurosciences, HUG, LUNIC Laboratory Geneva Neurocenter, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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23
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Deffieux T, Demené C, Tanter M. Functional Ultrasound Imaging: A New Imaging Modality for Neuroscience. Neuroscience 2021; 474:110-121. [PMID: 33727073 DOI: 10.1016/j.neuroscience.2021.03.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/15/2022]
Abstract
Ultrasound sensitivity to slow blood flow motion gained two orders of magnitude in the last decade thanks to the advent of ultrafast ultrasound imaging at thousands of frames per second. In neuroscience, this access to small cerebral vessels flow led to the introduction of ultrasound as a new and full-fledged neuroimaging modality. Much as functional MRI or functional optical imaging, functional Ultrasound (fUS) takes benefit of the neurovascular coupling. Its ease of use, portability, spatial and temporal resolution makes it an attractive tool for functional imaging of brain activity in preclinical imaging. A large and fast-growing number of studies in a wide variety of small to large animal models have demonstrated its potential for neuroscience research. Beyond preclinical imaging, first proof of concept applications in humans are promising and proved a clear clinical interest in particular in human neonates, per-operative surgery, or even for the development of non-invasive brain machine interfaces.
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Affiliation(s)
- Thomas Deffieux
- Institute of Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS UMR 8063, PSL Université Recherche, Paris, France.
| | - Charlie Demené
- Institute of Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS UMR 8063, PSL Université Recherche, Paris, France
| | - Mickael Tanter
- Institute of Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS UMR 8063, PSL Université Recherche, Paris, France
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24
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Heiles B, Terwiel D, Maresca D. The Advent of Biomolecular Ultrasound Imaging. Neuroscience 2021; 474:122-133. [PMID: 33727074 DOI: 10.1016/j.neuroscience.2021.03.011] [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: 11/16/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/23/2022]
Abstract
Ultrasound imaging is one of the most widely used modalities in clinical practice, revealing human prenatal development but also arterial function in the adult brain. Ultrasound waves travel deep within soft biological tissues and provide information about the motion and mechanical properties of internal organs. A drawback of ultrasound imaging is its limited ability to detect molecular targets due to a lack of cell-type specific acoustic contrast. To date, this limitation has been addressed by targeting synthetic ultrasound contrast agents to molecular targets. This molecular ultrasound imaging approach has proved to be successful but is restricted to the vascular space. Here, we introduce the nascent field of biomolecular ultrasound imaging, a molecular imaging approach that relies on genetically encoded acoustic biomolecules to interface ultrasound waves with cellular processes. We review ultrasound imaging applications bridging wave physics and chemical engineering with potential for deep brain imaging.
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Affiliation(s)
- Baptiste Heiles
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Dion Terwiel
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - David Maresca
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands.
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25
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Jakovljevic M, Yoon BC, Abou-Elkacem L, Hyun D, Li Y, Rubesova E, Dahl JJ. Blood Flow Imaging in the Neonatal Brain Using Angular Coherence Power Doppler. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:92-106. [PMID: 32746214 PMCID: PMC7864118 DOI: 10.1109/tuffc.2020.3010341] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Using ultrasound to image small vessels in the neonatal brain can be difficult in the presence of strong clutter from the surrounding tissue and with a neonate motion during the scan. We propose a coherence-based beamforming method, namely the short-lag angular coherence (SLAC) beamforming that suppresses incoherent noise and motion artifacts in Ultrafast data, and we demonstrate its applicability to improve detection of blood flow in the neonatal brain. Instead of estimating spatial coherence across the receive elements, SLAC utilizes the principle of acoustic reciprocity to estimate angular coherence from the beamsummed signals from different plane-wave transmits, which makes it computationally efficient and amenable to advanced beamforming techniques, such as f-k migration. The SLAC images of a simulated speckle phantom show similar edge resolution and texture size as the matching B-mode images, and reduced random noise in the background. We apply SLAC power Doppler (PD) to free-hand imaging of neonatal brain vasculature with long Doppler ensembles and show that: 1) it improves visualization of small vessels in the cortex compared to conventional PD and 2) it can be used for tracking of blood flow in the brain over time, meaning it could potentially improve the quality of free-hand functional ultrasound.
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26
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Costerus SA, Kortenbout AJ, Vos HJ, Govaert P, Tibboel D, Wijnen RMH, de Jong N, Bosch JG, de Graaff JC. Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns. Front Pediatr 2021; 9:656806. [PMID: 33829005 PMCID: PMC8019737 DOI: 10.3389/fped.2021.656806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aim: Newborns needing major surgical intervention are at risk of brain injury and impaired neurodevelopment later in life. Disturbance of cerebral perfusion might be an underlying factor. This study investigates the feasibility of serial transfontanellar ultrasound measurements of the pial arteries during neonatal surgery, and whether perioperative changes in cerebral perfusion can be observed and related to changes in the perioperative management. Methods: In this prospective, observational feasibility study, neonates with congenital diaphragmatic hernia and esophageal atresia scheduled for surgical treatment within the first 28 days of life were eligible for inclusion. We performed transfontanellar directional power Doppler and pulsed wave Doppler ultrasound during major high-risk non-cardiac neonatal surgery. Pial arteries were of interest for the measurements. Extracted Doppler ultrasound parameters were: peak systolic velocity, end diastolic velocity, the resistivity index and pulsatility index. Results: In 10 out of 14 patients it was possible to perform perioperative measurements; the others failed for logistic and technical reasons. In 6 out of 10 patients, it was feasible to perform serial intraoperative transfontanellar ultrasound measurements with directional power Doppler and pulsed wave Doppler of the same pial artery during neonatal surgery. Median peak systolic velocity was ranging between 5.7 and 7.0 cm s-1 and end diastolic velocity between 1.9 and 3.2 cm s-1. In patients with a vasoactive-inotropic score below 12 the trend of peak systolic velocity and end diastolic velocity corresponded with the mean arterial blood pressure trend. Conclusion: Perioperative transfontanellar ultrasound Doppler measurements of the pial arteries are feasible and provide new longitudinal data about perioperative cortical cerebral blood flow velocity. Trial Registration: https://www.trialregister.nl/trial/6972, identifier: NL6972.
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Affiliation(s)
- Sophie A Costerus
- Department of Paediatric Surgery, Erasmus MC University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Anna J Kortenbout
- Department of Biomedical Engineering, Thorax Centre, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Hendrik J Vos
- Department of Biomedical Engineering, Thorax Centre, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Paul Govaert
- Department of Neonatology, Ziekenhuis Netwerk Antwerp, Middelheim Antwerp, Belgium
| | - Dick Tibboel
- Department of Paediatric Surgery, Erasmus MC University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
| | - René M H Wijnen
- Department of Paediatric Surgery, Erasmus MC University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Nico de Jong
- Department of Biomedical Engineering, Thorax Centre, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Johan G Bosch
- Department of Biomedical Engineering, Thorax Centre, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Jurgen C de Graaff
- Department of Anaesthesiology, Erasmus MC University Medical Centre, Rotterdam, Netherlands
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27
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Liao J, Yang H, Yu J, Liang X, Chen Z. Progress in the Application of Ultrasound Elastography for Brain Diseases. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:2093-2104. [PMID: 32385862 DOI: 10.1002/jum.15317] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/28/2020] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
Ultrasound (US) can be used to evaluate the brain structure and nervous system damage. Patients with neurologic symptoms need rapid, noninvasive imaging with high spatial resolution and tissue contrast. Magnetic resonance imaging is currently the most sensitive and specific imaging method for evaluating neuropathologic conditions. This approach does present some challenges, such as the need to transport patients who may be seriously ill to the magnetic resonance imaging suite and the need for patients to remain for a considerable time. Cranial US provides a very valuable imaging method for clinicians, which can make a rapid diagnosis and evaluation without ionizing radiation. The main disadvantage of cranial US is its low sensitivity and specificity for subtle/early lesions. In recent years, with the rapid development of anatomic and functional US technology, the practicability of US diagnosis and intervention has been greatly improved. Ultrasound elastography may have the potential to improve the sensitivity and specificity of various cranial nerve conditions. Ultrasound elastography has received considerable critical attention, and an increasing number of studies have recognized its critical role in evaluating brain diseases. At present, US elastography has been applied to the evaluation of traumatic brain injury, ischemic stroke, intraoperative brain tumors, and hypoxic ischemic encephalopathy. The latest animal experiments and human clinical trial developments in the applications of US elastography for brain diseases are summarized in this review.
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Affiliation(s)
- Jianyi Liao
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huihui Yang
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jinsui Yu
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaowen Liang
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhiyi Chen
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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28
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Wu Q, Qiao Y, Guo R, Naveed S, Hirtz T, Li X, Fu Y, Wei Y, Deng G, Yang Y, Wu X, Ren TL. Triode-Mimicking Graphene Pressure Sensor with Positive Resistance Variation for Physiology and Motion Monitoring. ACS NANO 2020; 14:10104-10114. [PMID: 32667779 DOI: 10.1021/acsnano.0c03294] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The flexible pressure sensor is one of the essential components of the wearable device, which is a critical solution to the applications of artificial intelligence and human-computer interactions in the future. Due to its simple manufacturing process and measurement methods, research related to piezoresistive mechanical sensors is booming, and those sensors are already widely used in industry. However, existing pressure sensors are almost all based on negative resistance variations, making it difficult to reach a balance between the sensitivity and the detection range. Here, we demonstrated a low-cost flexible pressure sensor with a positive resistance-pressure response based on laser scribing graphene. The sensor can be customized and modulated to achieve both an ultrahigh sensitivity and a broad detection range. Furthermore, the device possesses the signal amplification property like a mechanical triode under the external pressure bias. Based on its amplification ability, varieties of physiological signals and human movements have been detected using our devices; then, an integrated gait monitoring system has been realized. The reported positive graphene pressure sensor has outstanding capability, showing a wide application range such as intelligent perception, an interactive device, and real-time health/motion monitoring.
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Affiliation(s)
- Qi Wu
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Yancong Qiao
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Rui Guo
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Shayan Naveed
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Thomas Hirtz
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Xiaoshi Li
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Yixin Fu
- Department of Electronic and Communication Engineering, Beijing Electronic Science and Technology Institute, Beijing 100070, China
| | - Yuhong Wei
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Ge Deng
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
- Department of Electronic Engineering, Tsinghua University, Beijing 100084, China
| | - Yi Yang
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Xiaoming Wu
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Tian-Ling Ren
- Institute of Microelectronics, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
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29
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Villemain O, Baranger J, Friedberg MK, Papadacci C, Dizeux A, Messas E, Tanter M, Pernot M, Mertens L. Ultrafast Ultrasound Imaging in Pediatric and Adult Cardiology. JACC Cardiovasc Imaging 2020; 13:1771-1791. [DOI: 10.1016/j.jcmg.2019.09.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 02/08/2023]
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30
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Abstract
In the past three decades, cerebral ultrasound (CUS) has become a trusted technique to study the neonatal brain. It is a relatively cheap, non-invasive, bedside neuroimaging method available in nearly every hospital. Traditionally, CUS was used to detect major abnormalities, such as intraventricular hemorrhage (IVH), periventricular hemorrhagic infarction, post-hemorrhagic ventricular dilatation, and (cystic) periventricular leukomalacia (cPVL). The use of different acoustic windows, such as the mastoid and posterior fontanel, and ongoing technological developments, allows for recognizing other lesion patterns (e.g., cerebellar hemorrhage, perforator stroke, developmental venous anomaly). The CUS technique is still being improved with the use of higher transducer frequencies (7.5-18 MHz), 3D applications, advances in vascular imaging (e.g. ultrafast plane wave imaging), and improved B-mode image processing. Nevertheless, the helpfulness of CUS still highly depends on observer skills, knowledge, and experience. In this special article, we discuss how to perform a dedicated state-of-the-art neonatal CUS, and we provide suggestions for structured reporting and quality assessment.
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Affiliation(s)
- Jeroen Dudink
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
| | - Sylke Jeanne Steggerda
- 0000000089452978grid.10419.3dDepartment of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sandra Horsch
- 0000 0000 8778 9382grid.491869.bDepartment of Neonatology, Helios Klinikum Berlin Buch, Berlin, Germany ,0000 0004 1937 0626grid.4714.6Department Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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31
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Puyo L, Paques M, Fink M, Sahel JA, Atlan M. Waveform analysis of human retinal and choroidal blood flow with laser Doppler holography. BIOMEDICAL OPTICS EXPRESS 2019; 10:4942-4963. [PMID: 31646021 PMCID: PMC6788604 DOI: 10.1364/boe.10.004942] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/14/2019] [Accepted: 06/27/2019] [Indexed: 05/20/2023]
Abstract
Laser Doppler holography was introduced as a full-field imaging technique to measure blood flow in the retina and choroid with an as yet unrivaled temporal resolution. We here investigate separating the different contributions to the power Doppler signal in order to isolate the flow waveforms of vessels in the posterior pole of the human eye. Distinct flow behaviors are found in retinal arteries and veins with seemingly interrelated waveforms. We demonstrate a full field mapping of the local resistivity index, and the possibility to perform unambiguous identification of retinal arteries and veins on the basis of their systolodiastolic variations. Finally we investigate the arterial flow waveforms in the retina and choroid and find synchronous and similar waveforms, although with a lower pulsatility in choroidal arteries. This work demonstrates the potential held by laser Doppler holography to study ocular hemodynamics in healthy and diseased eyes.
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Affiliation(s)
- Léo Puyo
- Institut Langevin, Centre National de la Recherche Scientifique (CNRS), Paris Sciences & Lettres (PSL University), École Supérieure de Physique et de Chimie Industrielles (ESPCI Paris) - 1 rue Jussieu, 75005 Paris, France
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
| | - Michel Paques
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Institut de la Vision-Sorbonne Universités, 17 rue Moreau, 75012 Paris, France
| | - Mathias Fink
- Institut Langevin, Centre National de la Recherche Scientifique (CNRS), Paris Sciences & Lettres (PSL University), École Supérieure de Physique et de Chimie Industrielles (ESPCI Paris) - 1 rue Jussieu, 75005 Paris, France
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
| | - José-Alain Sahel
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Institut de la Vision-Sorbonne Universités, 17 rue Moreau, 75012 Paris, France
| | - Michael Atlan
- Institut Langevin, Centre National de la Recherche Scientifique (CNRS), Paris Sciences & Lettres (PSL University), École Supérieure de Physique et de Chimie Industrielles (ESPCI Paris) - 1 rue Jussieu, 75005 Paris, France
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
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32
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Rocher L, Gennisson JL, Baranger J, Rachas A, Criton A, Izard V, Bertolloto M, Bellin MF, Correas JM. Ultrasensitive Doppler as a tool for the diagnosis of testicular ischemia during the Valsalva maneuver: a new way to explore varicoceles? Acta Radiol 2019; 60:1048-1056. [PMID: 30396287 DOI: 10.1177/0284185118810981] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background Varicocele is among the most common causes of male infertility because of various mechanism, including hypoxia. Purpose To evaluate testicular vascularization (TV) with ultrasensitive Doppler before and during the Valsalva maneuver (VM) and correlate TV changes to varicocele’s spermatic venous reflux graduated by color Doppler. Material and Methods From January to February 2016, 69 men (135 testis) referred for scrotal ultrasound were prospectively enrolled. An institutional review board approved the study. As gold standard, the spermatic venous reflux in the supratesticular region was assessed with color Doppler ultrasound and graded from 0 to III. A new ultra-sensitive Doppler (USD) sequence was performed on testicular parenchyma in an axial view. The TV changes before and during the VM were qualitatively graded from 0 to 2 using a visual scale by consensus. The vessels surface was quantified using customized MATLAB® software, and compared to the testicular delineated surface, resulting in a vessels surface ratio (VSR). The absolute and relative VSR difference before and during the VM was calculated. The qualitative scale and the quantitative VSR changes were compared with the spermatic venous reflux grade using an analysis of variance. Results A strong correlation has been found between the spermatic venous reflux grade and TV decrease during the VM using USD, for qualitative graduation as well as for quantitative measurement ( P < 0.0001). Conclusion TV assessed by USD decreased significantly during the VM in patients with varicocele; this decrease was significantly associated with spermatic venous reflux grade.
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Affiliation(s)
- Laurence Rocher
- Department of Adult Diagnostic and Interventional Radiology, Bicetre University Hospital, Le Kremlin Bicêtre, France
- Paris South Medical University, Le Kremlin Bicêtre, France
- Institut Langevin, ESPCI Paris, PSL Research University, Paris, France
- UMR8081, IR4M, Orsay Cedex, France
| | - Jean-Luc Gennisson
- Institut Langevin, ESPCI Paris, PSL Research University, Paris, France
- UMR8081, IR4M, Orsay Cedex, France
| | - Jérôme Baranger
- Institut Langevin, ESPCI Paris, PSL Research University, Paris, France
| | - Antoine Rachas
- Service de Santé publique et d’épidémiologie, Hôpitaux Paris Sud, Le Kremlin Bicêtre, France
| | - Aline Criton
- Supersonic Imagine, Aix en Provence cedex, France
| | - Vincent Izard
- Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | | | - Marie-France Bellin
- Department of Adult Diagnostic and Interventional Radiology, Bicetre University Hospital, Le Kremlin Bicêtre, France
- Paris South Medical University, Le Kremlin Bicêtre, France
- UMR8081, IR4M, Orsay Cedex, France
| | - Jean-Michel Correas
- Institut Langevin, ESPCI Paris, PSL Research University, Paris, France
- Paris Descartes University, Paris, France
- Department of Adult Radiology, Necker University Hospital, Paris, France
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33
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Papadacci C, Finel V, Villemain O, Goudot G, Provost J, Messas E, Tanter M, Pernot M. 4D simultaneous tissue and blood flow Doppler imaging: revisiting cardiac Doppler index with single heart beat 4D ultrafast echocardiography. Phys Med Biol 2019; 64:085013. [PMID: 30889552 DOI: 10.1088/1361-6560/ab1107] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The goal of this study was to demonstrate the feasibility of semi-automatic evaluation of cardiac Doppler indices in a single heartbeat in human hearts by performing 4D ultrafast echocardiography with a dedicated sequence of 4D simultaneous tissue and blood flow Doppler imaging. 4D echocardiography has the potential to improve the quantification of major cardiac indices by providing more reproducible and less user dependent measurements such as the quantification of left ventricle (LV) volume. The evaluation of Doppler indices, however, did not benefit yet from 4D echocardiography because of limited volume rates achieved in conventional volumetric color Doppler imaging but also because spectral Doppler estimation is still restricted to a single location. High volume rate (5200 volume s-1) transthoracic simultaneous tissue and blood flow Doppler acquisitions of three human LV were performed using a 4D ultrafast echocardiography scanner prototype during a single heartbeat. 4D color flow, 4D tissue Doppler cineloops and spectral Doppler at each voxel were computed. LV outflow tract, mitral inflow and basal inferoseptal locations were automatically detected. Doppler indices were derived at these locations and were compared against clinical 2D echocardiography. Blood flow Doppler indices E (early filling), A (atrial filling), E/A ratio, S (systolic ejection) and cardiac output were assessed on the three volunteers. Simultaneous tissue Doppler indices e' (mitral annular velocity peak), a' (late velocity peak), e'/a' ratio, s' (systolic annular velocity peak), E/e' ratio were also estimated. Standard deviations on three independent acquisitions were averaged over the indices and was found to be inferior to 4% and 8.5% for Doppler flow and tissue Doppler indices, respectively. Comparison against clinical 2D echocardiography gave a p value larger than 0.05 in average indicating no significant differences. 4D ultrafast echocardiography can quantify the major cardiac Doppler indices in a single heart beat acquisition.
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Affiliation(s)
- C Papadacci
- Physics For Medicine Paris, INSERM U1273, ESPCI Paris, PSL Research University, CNRS UMR 7587, France. Author to whom any correspondence should be addressed
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34
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Simon EG, Callé S, Remenieras JP. [Tomorrow's ultrasound imaging: When ultrasound systems become ultra-fast]. ACTA ACUST UNITED AC 2019; 47:395-397. [PMID: 30914358 DOI: 10.1016/j.gofs.2019.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Indexed: 01/18/2023]
Affiliation(s)
- E G Simon
- Service de gynécologie-obstétrique, médecine fœtale et stérilité conjugale, CHU de Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France; UMR 1253, iBrain, Inserm, université de Tours, 2, boulevard Tonnellé, 37032 Tours cedex 1, France.
| | - S Callé
- GREMAN, UMR CNRS 7347, université de Tours, 20, avenue Monge, 37200 Tours, France
| | - J P Remenieras
- UMR 1253, iBrain, Inserm, université de Tours, 2, boulevard Tonnellé, 37032 Tours cedex 1, France
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35
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Hwang M, Piskunowicz M, Darge K. Advanced Ultrasound Techniques for Pediatric Imaging. Pediatrics 2019; 143:e20182609. [PMID: 30808770 PMCID: PMC6398363 DOI: 10.1542/peds.2018-2609] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2018] [Indexed: 12/13/2022] Open
Abstract
Ultrasound has become a useful tool in the workup of pediatric patients because of the highly convenient, cost-effective, and safe nature of the examination. With rapid advancements in anatomic and functional ultrasound techniques over the recent years, the diagnostic and interventional utility of ultrasound has risen tremendously. Advanced ultrasound techniques constitute a suite of new technologies that employ microbubbles to provide contrast and enhance flow visualization, elastography to measure tissue stiffness, ultrafast Doppler to deliver high spatiotemporal resolution of flow, three- and four-dimensional technique to generate accurate spatiotemporal representation of anatomy, and high-frequency imaging to delineate anatomic structures at a resolution down to 30 μm. Application of these techniques can enhance the diagnosis of organ injury, viable tumor, and vascular pathologies at bedside. This has significant clinical implications in pediatric patients who are not easy candidates for lengthy MRI or radiation-requiring examination, and are also in need of a highly sensitive bedside technique for therapeutic guidance. To best use the currently available, advanced ultrasound techniques for pediatric patients, it is necessary to understand the diagnostic utility of each technique. In this review, we will educate the readers of emerging ultrasound techniques and their respective clinical applications.
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Affiliation(s)
- Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Maciej Piskunowicz
- Department of Radiology, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
- Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
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Demené C, Mairesse J, Baranger J, Tanter M, Baud O. Ultrafast Doppler for neonatal brain imaging. Neuroimage 2019; 185:851-856. [DOI: 10.1016/j.neuroimage.2018.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 04/03/2018] [Accepted: 04/08/2018] [Indexed: 12/18/2022] Open
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Demené C, Maresca D, Kohlhauer M, Lidouren F, Micheau P, Ghaleh B, Pernot M, Tissier R, Tanter M. Multi-parametric functional ultrasound imaging of cerebral hemodynamics in a cardiopulmonary resuscitation model. Sci Rep 2018; 8:16436. [PMID: 30401816 PMCID: PMC6219610 DOI: 10.1038/s41598-018-34307-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 10/11/2018] [Indexed: 01/11/2023] Open
Abstract
Patient mortality at one year reaches 90% after out-of-hospital cardiac arrest and resuscitation. Temperature management is one of the main strategies proposed to improve patient outcome after resuscitation and preclinical studies have shown neuroprotective effects when hypothermia is achieved rapidly, although the underlying mechanisms have not yet been elucidated. State-of-the-art brain imaging technologies can bring new insights into the early cerebral events taking place post cardiac arrest and resuscitation. In this paper, we characterized cerebral hemodynamics in a post-cardiac arrest rabbit model using functional ultrasound imaging. Ultrasound datasets were processed to map the dynamic changes in cerebral blood flow and cerebral vascular resistivity with a 10 second repetition rate while animals underwent cardiac arrest and a cardiopulmonary resuscitation. We report that a severe transient hyperemia takes place in the brain within the first twenty minutes post resuscitation, emphasizing the need for fast post-cardiac arrest care. Furthermore, we observed that this early hyperemic event is not spatially homogeneous and that maximal cerebral hyperemia happens in the hippocampus. Finally, we show that rapid cooling induced by total liquid ventilation reduces early cerebral hyperemia, which could explain the improved neurological outcome reported in preclinical studies.
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Affiliation(s)
- Charlie Demené
- Institut Langevin, ESPCI ParisTech, Paris Sciences & Lettres Research University, CNRS UMR7587, INSERM U979, Paris, France.
| | - David Maresca
- Institut Langevin, ESPCI ParisTech, Paris Sciences & Lettres Research University, CNRS UMR7587, INSERM U979, Paris, France
| | - Matthias Kohlhauer
- Inserm, U955, Equipe 03, Créteil, France
- UMR_S955, UPEC, Ecole Nationale Vétérinaire d'Alfort, 94700, Maisons-Alfort, France
| | - Fanny Lidouren
- Inserm, U955, Equipe 03, Créteil, France
- UMR_S955, UPEC, Ecole Nationale Vétérinaire d'Alfort, 94700, Maisons-Alfort, France
| | - Philippe Micheau
- Mechanical Engineering Dpt, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bijan Ghaleh
- Inserm, U955, Equipe 03, Créteil, France
- UMR_S955, UPEC, Ecole Nationale Vétérinaire d'Alfort, 94700, Maisons-Alfort, France
| | - Mathieu Pernot
- Institut Langevin, ESPCI ParisTech, Paris Sciences & Lettres Research University, CNRS UMR7587, INSERM U979, Paris, France
| | - Renaud Tissier
- Inserm, U955, Equipe 03, Créteil, France
- UMR_S955, UPEC, Ecole Nationale Vétérinaire d'Alfort, 94700, Maisons-Alfort, France
| | - Mickaël Tanter
- Institut Langevin, ESPCI ParisTech, Paris Sciences & Lettres Research University, CNRS UMR7587, INSERM U979, Paris, France
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Couture O, Hingot V, Heiles B, Muleki-Seya P, Tanter M. Ultrasound Localization Microscopy and Super-Resolution: A State of the Art. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:1304-1320. [PMID: 29994673 DOI: 10.1109/tuffc.2018.2850811] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Because it drives the compromise between resolution and penetration, the diffraction limit has long represented an unreachable summit to conquer in ultrasound imaging. Within a few years after the introduction of optical localization microscopy, we proposed its acoustic alter ego that exploits the micrometric localization of microbubble contrast agents to reconstruct the finest vessels in the body in-depth. Various groups now working on the subject are optimizing the localization precision, microbubble separation, acquisition time, tracking, and velocimetry to improve the capacity of ultrasound localization microscopy (ULM) to detect and distinguish vessels much smaller than the wavelength. It has since been used in vivo in the brain, the kidney, and tumors. In the clinic, ULM is bound to improve drastically our vision of the microvasculature, which could revolutionize the diagnosis of cancer, arteriosclerosis, stroke, and diabetes.
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Baranger J, Arnal B, Perren F, Baud O, Tanter M, Demene C. Adaptive Spatiotemporal SVD Clutter Filtering for Ultrafast Doppler Imaging Using Similarity of Spatial Singular Vectors. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:1574-1586. [PMID: 29969408 DOI: 10.1109/tmi.2018.2789499] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Singular value decomposition of ultrafast imaging ultrasonic data sets has recently been shown to build a vector basis far more adapted to the discrimination of tissue and blood flow than the classical Fourier basis, improving by large factor clutter filtering and blood flow estimation. However, the question of optimally estimating the boundary between the tissue subspace and the blood flow subspace remained unanswered. Here, we introduce an efficient estimator for automatic thresholding of subspaces and compare it to an exhaustive list of thirteen estimators that could achieve this task based on the main characteristics of the singular components, namely the singular values, the temporal singular vectors, and the spatial singular vectors. The performance of those fourteen estimators was tested in vitro in a large set of controlled experimental conditions with different tissue motion and flow speeds on a phantom. The estimator based on the degree of resemblance of spatial singular vectors outperformed all others. Apart from solving the thresholding problem, the additional benefit with this estimator was its denoising capabilities, strongly increasing the contrast to noise ratio and lowering the noise floor by at least 5 dB. This confirms that, contrary to conventional clutter filtering techniques that are almost exclusively based on temporal characteristics, efficient clutter filtering of ultrafast Doppler imaging cannot overlook space. Finally, this estimator was applied in vivo on various organs (human brain, kidney, carotid, and thyroid) and showed efficient clutter filtering and noise suppression, improving largely the dynamic range of the obtained ultrafast power Doppler images.
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40
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Rocher L, Gennisson JL, Ferlicot S, Criton A, Albiges L, Izard V, Bellin MF, Correas JM. Testicular ultrasensitive Doppler preliminary experience: a feasibility study. Acta Radiol 2018; 59:346-354. [PMID: 28569117 DOI: 10.1177/0284185117713350] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Ultrasensitive Doppler is a novel non-invasive ultrasound (US) Doppler technique that improves sensitivity and resolution for the detection of slow flow. Purpose To investigate the feasibility of ultrasensitive Doppler (USD) for testicular disease diagnosis, using both qualitative and quantitative results. Material and Methods This prospective study was conducted in 160 successive men referred for scrotal US including B-mode and conventional Color-Doppler. A new USD sequence and algorithm dedicated to academic research were implemented into the US system. The quality criterion for a successful examination was the detection of well delineated intratesticular vessels. Qualitative USD results were described in terms of tumor vascular architecture and flow intensity for different pathologies for 41 patients. The testicular vascularization (TV), defined as a vessel's surface ratio, was quantified using customized MATLAB® software and compared in azoospermic and normal patients. Results USD was acquired successfully in 153/160 patients (95.6%). The tumor vascular architecture differed depending on the nature of the tumors. Leydig cell tumors exhibited mostly circumferential vascularization, while germ cell tumors exhibited straight vessels through the tumors, or anarchic vascular maps. USD improved the diagnostic performance of testicular Doppler US in a case of incomplete spermatic cord torsion and acute epididymitis. The reproducibility of TV measurements established an interclass correlation of 0.801. Non-Klinefelter syndrome non-obstructive azoospermia patients exhibited a lower TV compared to normal patients, to Klinefelter syndrome, and to obstructive azoospermia patients ( P < 0.002, P < 0.005, and P < 0.05, respectively). Conclusion Testicular USD can become a promising technique for improving US diagnosis of tumors, acute scrotum, and for determining infertility status.
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Affiliation(s)
- Laurence Rocher
- Department of Adult Diagnostic and Interventional Radiology, Bicetre University Hospital, Le Kremlin Bicêtre, France
- Paris South Medical University, Le Kremlin Bicêtre, France
- Institut Langevin, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM U979, Paris, France
| | - Jean-Luc Gennisson
- Institut Langevin, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM U979, Paris, France
| | - Sophie Ferlicot
- Paris South Medical University, Le Kremlin Bicêtre, France
- Department of Pathology, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Aline Criton
- Supersonic Imagine, Aix en Provence cedex, France
| | - Laurence Albiges
- Paris South Medical University, Le Kremlin Bicêtre, France
- Department of Oncology, Institut Gustave Roussy, Villejuif, France
| | - Vincent Izard
- Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Marie France Bellin
- Department of Adult Diagnostic and Interventional Radiology, Bicetre University Hospital, Le Kremlin Bicêtre, France
- Paris South Medical University, Le Kremlin Bicêtre, France
| | - Jean-Michel Correas
- Institut Langevin, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM U979, Paris, France
- Department of Adult Radiology, Necker University Hospital, Paris, France
- Paris Descartes University, Paris, France
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41
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Baud O. [Prematurity, progress and challenges]. SOINS. PÉDIATRIE, PUÉRICULTURE 2017; 38:10-14. [PMID: 29162252 DOI: 10.1016/j.spp.2017.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Prematurity is one of the main causes of neonatal mortality and comorbidities, and longer term sequalae. The survival rate and quality of life of premature babies has however progressed significantly and infants benefit from improved monitoring and long-term follow-up. Notable advances have been made in the area of developmental care, although their implementation in units needs to be improved. Innovations in perinatology should emerge in the years ahead.
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Affiliation(s)
- Olivier Baud
- Inserm U1141,Université Paris-Diderot, Sorbonne Paris Cité,Service de réanimation et pédiatrie néonatales, Hôpital universitaire Robert-Debré, AP-HP, 48 boulevard Sérurier, 75019, Paris, France.
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Lou Y, Yen JT. Improved contrast for high frame rate imaging using coherent compounding combined with spatial matched filtering. ULTRASONICS 2017; 78:152-161. [PMID: 28351747 DOI: 10.1016/j.ultras.2017.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 02/11/2017] [Accepted: 03/17/2017] [Indexed: 06/06/2023]
Abstract
The concept of high frame rate ultrasound imaging (typically greater than 1000 frames per second) has inspired new fields of clinical applications for ultrasound imaging such as fast cardiovascular imaging, fast Doppler imaging and real-time 3D imaging. Coherent plane-wave compounding is a promising beamforming technique to achieve high frame rate imaging. By combining echoes from plane waves with different angles, dynamic transmit focusing is efficiently accomplished at all points in the image field. Meanwhile, the image frame rate can still be kept at a high level. Spatial matched filtering (SMF) with plane-wave insonification is a novel ultrafast beamforming method. An analytical study shows that SMF is equivalent to synthetic aperture methods that can provide dynamic transmit-receive focusing throughout the field of view. Experimental results show that plane-wave SMF has better performance than dynamic-receive focusing. In this paper, we propose integrating coherent plane-wave compounding with SMF to obtain greater image contrast. By using a combination of SMF beamformed images, image contrast is improved without degrading its high frame rate capabilities. The performance of compounded SMF (CSMF) is evaluated and compared with that of synthetic aperture focusing technique (SAFT) beamforming and compounded dynamic-receive-focus (CDRF) beamforming. The image quality of different beamforming methods was quantified in terms of contrast-to-noise ratio (CNR). Our results show that the new SMF based plane-wave compounding method provides better contrast than DAS based compounding method. Also CSMF can obtain a similar contrast level to dynamic transmit-receive focusing with only 21 transmit events.
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Affiliation(s)
- Yang Lou
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA.
| | - Jesse T Yen
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
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43
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Urs R, Ketterling JA, Silverman RH. Ultrafast Ultrasound Imaging of Ocular Anatomy and Blood Flow. Invest Ophthalmol Vis Sci 2017; 57:3810-6. [PMID: 27428169 PMCID: PMC5015817 DOI: 10.1167/iovs.16-19538] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Ophthalmic ultrasound imaging is currently performed with mechanically scanned single-element probes. These probes have limited capabilities overall and lack the ability to image blood flow. Linear-array systems are able to detect blood flow, but these systems exceed ophthalmic acoustic intensity safety guidelines. Our aim was to implement and evaluate a new linear-array–based technology, compound coherent plane-wave ultrasound, which offers ultrafast imaging and depiction of blood flow at safe acoustic intensity levels. Methods We compared acoustic intensity generated by a 128-element, 18-MHz linear array operated in conventionally focused and plane-wave modes and characterized signal-to-noise ratio (SNR) and lateral resolution. We developed plane-wave B-mode, real-time color-flow, and high-resolution depiction of slow flow in postprocessed data collected continuously at a rate of 20,000 frames/s. We acquired in vivo images of the posterior pole of the eye by compounding plane-wave images acquired over ±10° and produced images depicting orbital and choroidal blood flow. Results With the array operated conventionally, Doppler modes exceeded Food and Drug Administration safety guidelines, but plane-wave modalities were well within guidelines. Plane-wave data allowed generation of high-quality compound B-mode images, with SNR increasing with the number of compounded frames. Real-time color-flow Doppler readily visualized orbital blood flow. Postprocessing of continuously acquired data blocks of 1.6-second duration allowed high-resolution depiction of orbital and choroidal flow over the cardiac cycle. Conclusions Newly developed high-frequency linear arrays in combination with plane-wave techniques present opportunities for the evaluation of ocular anatomy and blood flow, as well as visualization and analysis of other transient phenomena such as vessel wall motion over the cardiac cycle and saccade-induced vitreous motion.
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Affiliation(s)
- Raksha Urs
- Department of Ophthalmology, Columbia University Medical Center, New York, New York, United States
| | - Jeffrey A Ketterling
- Frederic L. Lizzi Center for Biomedical Engineering, Riverside Research, New York, New York, United States
| | - Ronald H Silverman
- Department of Ophthalmology, Columbia University Medical Center, New York, New York, United States 2Frederic L. Lizzi Center for Biomedical Engineering, Riverside Research, New York, New York, United States
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44
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Li YL, Hyun D, Abou-Elkacem L, Willmann JK, Dahl JJ. Visualization of Small-Diameter Vessels by Reduction of Incoherent Reverberation With Coherent Flow Power Doppler. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2016; 63:1878-1889. [PMID: 27824565 PMCID: PMC5154731 DOI: 10.1109/tuffc.2016.2616112] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Power Doppler (PD) imaging is a widely used technique for flow detection. Despite the wide use of Doppler ultrasound, limitations exist in the ability of Doppler ultrasound to assess slow flow in the small-diameter vasculature, such as the maternal spiral arteries and fetal villous arteries of the placenta and focal liver lesions. The sensitivity of PD in small vessel detection is limited by the low signal produced by slow flow and the noise associated with small vessels. The noise sources include electronic noise, stationary or slowly moving tissue clutter, reverberation clutter, and off-axis scattering from tissue, among others. In order to provide more sensitive detection of slow flow in small diameter vessels, a coherent flow imaging technique, termed coherent flow PD (CFPD), is characterized and evaluated with simulation, flow phantom experiment studies, and an in vivo animal small vessel detection study. CFPD imaging was introduced as a technique to detect slow blood flow. It has been demonstrated to detect slow flow below the detection threshold of conventional PD imaging using identical pulse sequences and filter parameters. In this paper, we compare CFPD with PD in the detection of blood flow in small-diameter vessels. The results from the study suggest that CFPD is able to provide a 7.5-12.5-dB increase in the signal-to-noise ratio (SNR) over PD images for the same physiological conditions and is less susceptible to reverberation clutter and thermal noise. Due to the increase in SNR, CFPD is able to detect small vessels in high channel noise cases, for which PD was unable to generate enough contrast to observe the vessel.
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45
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Peeples ES, Mehic E, Mourad PD, Juul SE. Fast Doppler as a novel bedside measure of cerebral perfusion in preterm infants. Pediatr Res 2016; 79:333-8. [PMID: 26539662 DOI: 10.1038/pr.2015.227] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/12/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral perfusion and autoregulation in preterm infants. METHODS This is a prospective pilot study using fast Doppler ultrasound to assess blood flow velocity in the basal ganglia of 19 subjects born at 26-32 wk gestation. Intraclass correlation provided a measure of test-retest reliability, and linear regression of cerebral blood flow velocity and heart rate or blood pressure allowed for estimations of autoregulatory ability. RESULTS The intraclass correlation when imaging in the first 48 h of life was 0.634. We found significant and independent correlations between the systolic blood flow velocity and both systolic blood pressure and heart rate (P = 0.015 and 0.012 respectively) only in the 26-28 wk gestational age infants in the first 48 h of life. CONCLUSION Our results suggest that fast Doppler provides reliable bedside measurements of cerebral blood flow velocity at the tissue level in premature infants, acting as a proxy for cerebral tissue perfusion. Additionally, autoregulation appears to be impaired in the extremely preterm infants, even within a normal range of blood pressures.
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Affiliation(s)
- Eric S Peeples
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Edin Mehic
- Department of Neurological Surgery, University of Washington, Seattle, Washington
| | - Pierre D Mourad
- Department of Neurological Surgery, University of Washington, Seattle, Washington.,Division of Engineering and Mathematics, University of Washington, Seattle, Washington
| | - Sandra E Juul
- Department of Pediatrics, University of Washington, Seattle, Washington
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Demené C, Tiran E, Sieu LA, Bergel A, Gennisson JL, Pernot M, Deffieux T, Cohen I, Tanter M. 4D microvascular imaging based on ultrafast Doppler tomography. Neuroimage 2016; 127:472-483. [DOI: 10.1016/j.neuroimage.2015.11.014] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 12/21/2022] Open
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Hypothermic Total Liquid Ventilation Is Highly Protective Through Cerebral Hemodynamic Preservation and Sepsis-Like Mitigation After Asphyxial Cardiac Arrest. Crit Care Med 2015; 43:e420-30. [PMID: 26110489 DOI: 10.1097/ccm.0000000000001160] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Total liquid ventilation provides ultrafast and potently neuro- and cardioprotective cooling after shockable cardiac arrest and myocardial infarction in animals. Our goal was to decipher the effect of hypothermic total liquid ventilation on the systemic and cerebral response to asphyxial cardiac arrest using an original pressure- and volume-controlled ventilation strategy in rabbits. DESIGN Randomized animal study. SETTING Academic research laboratory. SUBJECTS New Zealand Rabbits. INTERVENTIONS Thirty-six rabbits were submitted to 13 minutes of asphyxia, leading to cardiac arrest. After resumption of spontaneous circulation, they underwent either normothermic life support (control group, n = 12) or hypothermia induced by either 30 minutes of total liquid ventilation (total liquid ventilation group, n = 12) or IV cold saline (conventional cooling group, n = 12). MEASUREMENTS AND MAIN RESULTS Ultrafast cooling with total liquid ventilation (32 °C within 5 min in the esophagus) dramatically attenuated the post-cardiac arrest syndrome regarding survival, neurologic dysfunction, and histologic lesions (brain, heart, kidneys, liver, and lungs). Final survival rate achieved 58% versus 0% and 8% in total liquid ventilation, control, and conventional cooling groups (p < 0.05), respectively. This was accompanied by an early preservation of the blood-brain barrier integrity and cerebral hemodynamics as well as reduction in the immediate reactive oxygen species production in the brain, heart, and kidneys after cardiac arrest. Later on, total liquid ventilation also mitigated the systemic inflammatory response through alteration of monocyte chemoattractant protein-1, interleukin-1β, and interleukin-8 transcripts levels compared with control. In the conventional cooling group, cooling was achieved more slowly (32 °C within 90-120 min in the esophagus), providing none of the above-mentioned systemic or organ protection. CONCLUSIONS Ultrafast cooling by total liquid ventilation limits the post-cardiac arrest syndrome after asphyxial cardiac arrest in rabbits. This protection involves an early limitation in reactive oxidative species production, blood-brain barrier disruption, and delayed preservation against the systemic inflammatory response.
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Demené C, Deffieux T, Pernot M, Osmanski BF, Biran V, Gennisson JL, Sieu LA, Bergel A, Franqui S, Correas JM, Cohen I, Baud O, Tanter M. Spatiotemporal Clutter Filtering of Ultrafast Ultrasound Data Highly Increases Doppler and fUltrasound Sensitivity. IEEE TRANSACTIONS ON MEDICAL IMAGING 2015; 34:2271-85. [PMID: 25955583 DOI: 10.1109/tmi.2015.2428634] [Citation(s) in RCA: 427] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Ultrafast ultrasonic imaging is a rapidly developing field based on the unfocused transmission of plane or diverging ultrasound waves. This recent approach to ultrasound imaging leads to a large increase in raw ultrasound data available per acquisition. Bigger synchronous ultrasound imaging datasets can be exploited in order to strongly improve the discrimination between tissue and blood motion in the field of Doppler imaging. Here we propose a spatiotemporal singular value decomposition clutter rejection of ultrasonic data acquired at ultrafast frame rate. The singular value decomposition (SVD) takes benefits of the different features of tissue and blood motion in terms of spatiotemporal coherence and strongly outperforms conventional clutter rejection filters based on high pass temporal filtering. Whereas classical clutter filters operate on the temporal dimension only, SVD clutter filtering provides up to a four-dimensional approach (3D in space and 1D in time). We demonstrate the performance of SVD clutter filtering with a flow phantom study that showed an increased performance compared to other classical filters (better contrast to noise ratio with tissue motion between 1 and 10mm/s and axial blood flow as low as 2.6 mm/s). SVD clutter filtering revealed previously undetected blood flows such as microvascular networks or blood flows corrupted by significant tissue or probe motion artifacts. We report in vivo applications including small animal fUltrasound brain imaging (blood flow detection limit of 0.5 mm/s) and several clinical imaging cases, such as neonate brain imaging, liver or kidney Doppler imaging.
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Serov AS, Salafia C, Grebenkov DS, Filoche M. The role of morphology in mathematical models of placental gas exchange. J Appl Physiol (1985) 2015; 120:17-28. [PMID: 26494446 DOI: 10.1152/japplphysiol.00543.2015] [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: 06/29/2015] [Accepted: 10/08/2015] [Indexed: 02/07/2023] Open
Abstract
The performance of the placenta as a gas exchanger has a direct impact on the future health of the newborn. To provide accurate estimates of respiratory gas exchange rates, placenta models need to account for both the physiology of exchange and the organ morphology. While the former has been extensively studied, accounting for the latter is still a challenge. The geometrical complexity of placental structure requires use of carefully crafted approximations. We present here the state of the art of respiratory gas exchange placenta modeling and demonstrate the influence of the morphology description on model predictions. Advantages and shortcomings of various classes of models are discussed, and experimental techniques that may be used for model validation are summarized. Several directions for future development are suggested.
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Affiliation(s)
- A S Serov
- Physique de la Matière Condensée, Centre National de la Recherche Scientifique, Ecole Polytechnique, Palaiseau, France; and
| | - C Salafia
- Placental Analytics, LLC, Larchmont, New York
| | - D S Grebenkov
- Physique de la Matière Condensée, Centre National de la Recherche Scientifique, Ecole Polytechnique, Palaiseau, France; and
| | - M Filoche
- Physique de la Matière Condensée, Centre National de la Recherche Scientifique, Ecole Polytechnique, Palaiseau, France; and
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50
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Errico C, Osmanski BF, Pezet S, Couture O, Lenkei Z, Tanter M. Transcranial functional ultrasound imaging of the brain using microbubble-enhanced ultrasensitive Doppler. Neuroimage 2015; 124:752-761. [PMID: 26416649 PMCID: PMC4686564 DOI: 10.1016/j.neuroimage.2015.09.037] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/13/2015] [Accepted: 09/14/2015] [Indexed: 11/15/2022] Open
Abstract
Functional ultrasound (fUS) is a novel neuroimaging technique, based on high-sensitivity ultrafast Doppler imaging of cerebral blood volume, capable of measuring brain activation and connectivity in rodents with high spatiotemporal resolution (100 μm, 1 ms). However, the skull attenuates acoustic waves, so fUS in rats currently requires craniotomy or a thinned-skull window. Here we propose a non-invasive approach by enhancing the fUS signal with a contrast agent, inert gas microbubbles. Plane-wave illumination of the brain at high frame rate (500 Hz compounded sequence with three tilted plane waves, PRF = 1500Hz with a 128 element 15 MHz linear transducer), yields highly-resolved neurovascular maps. We compared fUS imaging performance through the intact skull bone (transcranial fUS) versus a thinned-skull window in the same animal. First, we show that the vascular network of the adult rat brain can be imaged transcranially only after a bolus intravenous injection of microbubbles, which leads to a 9 dB gain in the contrast-to-tissue ratio. Next, we demonstrate that functional increase in the blood volume of the primary sensory cortex after targeted electrical-evoked stimulations of the sciatic nerve is observable transcranially in presence of contrast agents, with high reproducibility (Pearson's coefficient ρ = 0.7 ± 0.1, p = 0.85). Our work demonstrates that the combination of ultrafast Doppler imaging and injection of contrast agent allows non-invasive functional brain imaging through the intact skull bone in rats. These results should ease non-invasive longitudinal studies in rodents and open a promising perspective for the adoption of highly resolved fUS approaches for the adult human brain. We combined ultrafast sensitive Doppler with contrast-enhanced ultrasound imaging. We retrieved highly-resolved neurovascular transcranial maps with contrast agents. The presence of microbubbles compensates for the attenuation from the skull. fUS is sensitive to the local hyperemia in the rat brain through the skull with microbubbles. Transcranial fUS imaging allows non-invasive functional brain studies in rodents.
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Affiliation(s)
- Claudia Errico
- INSERM, Institut Langevin, 1 rue Jussieu, 75005, Paris, France; ESPCI ParisTech, PSL Research University, Institut Langevin, 1 rue Jussieu, 75005, Paris, France; CNRS, Institut Langevin, 1 rue Jussieu, 75005, Paris, France
| | - Bruno-Félix Osmanski
- INSERM, Institut Langevin, 1 rue Jussieu, 75005, Paris, France; ESPCI ParisTech, PSL Research University, Institut Langevin, 1 rue Jussieu, 75005, Paris, France; CNRS, Institut Langevin, 1 rue Jussieu, 75005, Paris, France
| | - Sophie Pezet
- CNRS, UMR 8249, 10 rue Vauquelin, 75005 Paris, France; Brain Plasticity Unit, ESPCI-ParisTech, PSL Research University 10 rue Vauquelin, 75005 Paris, France
| | - Olivier Couture
- INSERM, Institut Langevin, 1 rue Jussieu, 75005, Paris, France; ESPCI ParisTech, PSL Research University, Institut Langevin, 1 rue Jussieu, 75005, Paris, France; CNRS, Institut Langevin, 1 rue Jussieu, 75005, Paris, France
| | - Zsolt Lenkei
- CNRS, UMR 8249, 10 rue Vauquelin, 75005 Paris, France; Brain Plasticity Unit, ESPCI-ParisTech, PSL Research University 10 rue Vauquelin, 75005 Paris, France
| | - Mickael Tanter
- INSERM, Institut Langevin, 1 rue Jussieu, 75005, Paris, France; ESPCI ParisTech, PSL Research University, Institut Langevin, 1 rue Jussieu, 75005, Paris, France; CNRS, Institut Langevin, 1 rue Jussieu, 75005, Paris, France.
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