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Gu O, He B, Xiong L, Zhang Y, Li Z, Lang X. Reconstructive interpolation for pulse wave estimation to improve local PWV measurement of carotid artery. Med Biol Eng Comput 2024; 62:1459-1473. [PMID: 38252371 DOI: 10.1007/s11517-023-03008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Ultrasonic transit time (TT)-based local pulse wave velocity (PWV) measurement is defined as the distance between two beam positions on a segment of common carotid artery (CCA) divided by the TT in the pulse wave propagation. However, the arterial wall motions (AWMs) estimated from ultrasonic radio frequency (RF) signals with a limited number of frames using the motion tracking are typically discrete. In this work, we develop a method involving motion tracking combined with reconstructive interpolation (MTRI) to reduce the quantification errors in the estimated PWs, and thereby improve the accuracy of the TT-based local PWV measurement for CCA. For each beam position, normalized cross-correlation functions (NCCFs) between the reference (the first frame) and comparison (the remaining frames) RF signals are calculated. Thereafter, the reconstructive interpolation is performed in the neighborhood of the NCCFs' peak to identify the interpolation-deduced peak locations, which are more exact than the original ones. According to which, the improved AWMs are obtained to calculate their TT along a segment of the CCA. Finally, the local PWV is measured by applying a linear regression fit to the time-distance result. In ultrasound simulations based on the pulse wave propagation models of young, middle-aged, and elderly groups, the MTRI method with different numbers of interpolated samples was used to estimate AWMs and local PWVs. Normalized root mean squared errors (NRMSEs) between the estimated and preset values of the AWMs and local PWVs were calculated and compared with ones without interpolation. The means of the NRMSEs for the AWMs and local PWVs based on the MTRI method with one interpolated sample decrease from 1.14% to 0.60% and 7.48% to 4.61%, respectively. Moreover, Bland-Altman analysis and coefficient of variation were used to validate the performance of the MTRI method based on the measured local PWVs of 30 healthy subjects. In conclusion, the reconstructive interpolation for the pulse wave estimation improves the accuracy and repeatability of the carotid local PWV measurement.
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Affiliation(s)
- Ouyang Gu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Bingbing He
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China.
| | - Li Xiong
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Zhiyao Li
- Department of Ultrasound, the Third Affiliated Hospital of Kunming Medical College, Kunming, 650118, China
| | - Xun Lang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
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Duan C, Anderson JL, Schepers LE, Damen FW, Cox A, Goergen CJ, Sivasankar PM. In Vivo Visualization and Quantification of Rat Laryngeal Blood Supply After Hydration Challenge. Laryngoscope 2024; 134:779-785. [PMID: 37584333 PMCID: PMC10842383 DOI: 10.1002/lary.30965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/31/2023] [Accepted: 08/01/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVES Systemic dehydration decreases total body blood volume; however, hemodynamic alterations at the level of local organs, such as the larynx, remain unclear. Here we sought to quantify superior thyroid artery (STA) blood flow after dehydration and rehydration using in vivo magnetic resonance angiography (MRA) and ultrasound imaging in a rat model. METHODS Male Sprague-Dawley rats (N = 17) were included in this prospective, repeated measures design. Rats first underwent MRA to determine baseline STA cross-sectional area, followed by high-frequency in vivo ultrasound imaging to measure STA blood velocity at baseline. Next, rats were systemically dehydrated (water withholding), followed by rehydration (water ad-lib). Ultrasound imaging was repeated immediately after dehydration and following rehydration. The STA blood velocity and STA cross-sectional area were used to compute STA blood flow. Three rats served as temporal controls for ultrasound imaging. To determine if the challenges to hydration status affected the STA cross-sectional area, four rats underwent only MRA at baseline, dehydration, and rehydration. RESULTS Systemic dehydration resulted in 10.5% average body weight loss. Rehydration resulted in average body weight gain of 10.9%. Statistically significant reductions were observed in STA mean blood flow rate after dehydration. Rehydration reversed these changes to pre-dehydration levels. No significant differences were observed in STA cross-sectional area with dehydration or rehydration. CONCLUSION Systemic dehydration decreased blood flow in the superior thyroid artery. Rehydration restored blood flow in the STA. Change in hydration status did not alter the STA cross-sectional area. These preliminary findings demonstrate the feasibility of using ultrasound and MRA to quantify hemodynamic changes and visualize laryngeal blood vessels. LEVEL OF EVIDENCE NA Laryngoscope, 134:779-785, 2024.
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Affiliation(s)
- Chenwei Duan
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | | | - Luke E. Schepers
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Frederick W. Damen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
- Indiana University School of Medicine, Indianapolis, IN
| | - Abigail Cox
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN
| | - Craig J. Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
- Indiana University School of Medicine, Indianapolis, IN
| | - Preeti M. Sivasankar
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
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Anand KS, Torres G, Homeister JW, Caughey MC, Gallippi CM. Comparing Focused-Tracked and Plane Wave-Tracked ARFI Log(VoA) In Silico and in Application to Human Carotid Atherosclerotic Plaque, Ex Vivo. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:636-652. [PMID: 37216241 PMCID: PMC10330788 DOI: 10.1109/tuffc.2023.3278495] [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: 05/24/2023]
Abstract
A significant risk factor for ischemic stroke is carotid atherosclerotic plaque that is susceptible to rupture, with rupture potential conveyed by plaque morphology. Human carotid plaque composition and structure have been delineated noninvasively and in vivo by evaluating log(VoA), a parameter derived as the decadic log of the second time derivative of displacement induced by an acoustic radiation force impulse (ARFI). In prior work, ARFI-induced displacement was measured using conventional focused tracking; however, this requires a long data acquisition period, thereby reducing framerate. We herein evaluate if ARFI log(VoA) framerate can be increased without a reduction in plaque imaging performance using plane wave tracking instead. In silico, both focused- and plane wave-tracked log(VoA) decreased with increasing echobrightness, quantified as signal-to-noise ratio (SNR), but did not vary with material elasticity for SNRs below 40 dB. For SNRs of 40-60 dB, both focused- and plane wave-tracked log(VoA) varied with SNR and material elasticity. Above 60 dB SNR, both focused- and plane wave-tracked log(VoA) varied with material elasticity alone. This suggests that log(VoA) discriminates features according to a combination of their echobrightness and mechanical property. Further, while both focused- and plane-wave tracked log(VoA) values were artifactually inflated by mechanical reflections at inclusion boundaries, plane wave-tracked log(VoA) was more strongly impacted by off-axis scattering. Applied to three excised human cadaveric carotid plaques with spatially aligned histological validation, both log(VoA) methods detected regions of lipid, collagen, and calcium (CAL) deposits. These findings support that plane wave tracking performs comparably to focused tracking for log(VoA) imaging and that plane wave-tracked log(VoA) is a viable approach to discriminating clinically relevant atherosclerotic plaque features at a 30-fold higher framerate than by focused tracking.
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Mori S, Arakawa M, Kanai H. Lateral M-Mode: Ultrasound Visualization of Displacement Along Longitudinal Direction at Intima-Media Complex. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:875-888. [PMID: 36623971 DOI: 10.1016/j.ultrasmedbio.2022.11.014] [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: 04/29/2022] [Revised: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
Quantification of the dynamics of the carotid artery wall is useful in evaluating arteriosclerosis and atherosclerosis. As the carotid artery wall moves not only in the radial direction but also in the longitudinal direction, longitudinal movement should be considered in the analysis of the dynamic properties of the carotid artery wall. In this study, we propose a "lateral M-mode" method for visualizing the longitudinal movement of the intima-media complex (IMC). For the lateral M-mode, we set the target line in the longitudinal direction along the IMC and visualize the signals on the target line frame-by-frame by correcting the position of the target line along the radial displacement estimated by the phased tracking method. Differentiating the envelope signals between consecutive ultrasound beams was effective in visualizing the lateral movement of the IMC. The precision of the longitudinal displacement of the IMC estimated using the conventional block-matching method was validated by comparing it with the lateral M-mode. Because the conventional M-mode sequence plays an important role in evaluation of the dynamics of various tissues, the proposed "lateral M-mode" contributes to a detailed understanding of vascular dynamics and the development of diagnostic methods for vascular diseases.
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Affiliation(s)
- Shohei Mori
- Graduate School of Engineering, Tohoku University, Sendai, Japan.
| | - Mototaka Arakawa
- Graduate School of Engineering, Tohoku University, Sendai, Japan; Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| | - Hiroshi Kanai
- Graduate School of Engineering, Tohoku University, Sendai, Japan; Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
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Liu S, Li P, Tan Y, Ding G, Peng B. A robust local pulse wave imaging method based on digital image processing techniques. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:6721-6734. [PMID: 37161125 DOI: 10.3934/mbe.2023289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The original diameter velocity loop method (ln(D)U-loop) cannot accurately extract the blood vessel diameter waveform when the quality of ultrasound image data is not high (such as obesity, age, and the operation of the ultrasound doctor), so it is unable to measure the pulse wave velocity (PWV) of the ascending aorta. This study proposes a diameter waveform extraction method combining threshold, gradient filtering, and the center of gravity method. At the same time, the linear regression method of searching for the rising point of the systolic period is replaced by the optimal average of two linear regression methods. This method can also extract the diameter waveform with poor-quality images and obtain a more accurate PWV. In vivo experimental data from 17 (age 60.5 ± 9.2) elderly patients with cerebral infarction and 12 (age 32.5 ± 5.6) healthy young adults were used for processing, and the results showed that the mean PWV using the ln(D)U-loop method was 12.56 (SD = 3.47) ms-1 for patients with cerebral infarction and 6.81 (SD = 1.73) ms-1 for healthy young adults. The PWV results based on the Wilcoxon rank-sum test and calculated based on the improved ln(D)U-loop method were both statistically significant (p < 0.01). The agreement analysis (Bland-Altman analysis) between the QA-loop and ln(D)U-loop methods showed that the mean deviation of the measured PWV was 0.07 m/s and the standard deviation of the deviation was 1.18 m/s. The experimental results demonstrated the effectiveness of the improved ln(D)U-loop method proposed in this paper on poor-quality images. This study can improve the possibility of the ln(D)U-loop method being widely used in the clinical measurement of ascending aortic PWV.
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Affiliation(s)
- Shuyan Liu
- School of Computer Science, Southwest Petroleum University, Chengdu 610500, China
| | - Peilin Li
- School of Computer Science, Southwest Petroleum University, Chengdu 610500, China
| | - Yuanhao Tan
- School of Computer Science, Southwest Petroleum University, Chengdu 610500, China
| | - Geqi Ding
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Bo Peng
- School of Computer Science, Southwest Petroleum University, Chengdu 610500, China
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
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Lee HK, Capron CB, Liu HC, Roy T, Guddati MN, Greenleaf JF, Urban MW. Measurement of wave propagation through a tube using dual transducers for elastography in arteries. Phys Med Biol 2022; 67:10.1088/1361-6560/ac9c3f. [PMID: 36265476 PMCID: PMC10019347 DOI: 10.1088/1361-6560/ac9c3f] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/20/2022] [Indexed: 11/27/2022]
Abstract
Objective.Measuring waves induced with acoustic radiation force (ARF) in arteries has been studied over the last decade. To date, it remains a challenge to quantitatively assess the local arterial biomechanical properties. The cylindrical shape and waveguide behavior of waves propagating in the arterial wall pose complexities to determining the mechanical properties of the artery.Approach. In this paper, an artery-mimicking tube in water is examined utilizing three-dimensional measurements. The cross-section of the tube is measured while a transducer is translated over 41 different positions along the length of the tube. Motion in the radial direction is calculated using two components of motion which are measured from the two orthogonal views of the cross-section. This enables more accurate estimation of motion along the circumference of tube.Main results. The results provide more information to categorize the motion in tube wall into two types of responses: a transient response and a steady state response. The transient response is caused by ARF application and the waves travel along the length of the tube for a relatively short period of time. This corresponds to the axial and circumferential propagating waves. The two circumferential waves travel along the circumference of tube in CW (clockwise) and CCW (counter-clockwise) direction and result in a standing wave. By using a directional filter, the two waves were successfully separated, and their propagation was more clearly visualized. As a steady state response, a circumferential mode is generated showing a symmetric motion (i.e. the proximal and distal walls move in the opposite direction) following the transient response.Significance.This study provides a more comprehensive understanding of the waves produced in an artery-mimicking tube with ARF application, which will provide opportunities for improving measurement of arterial mechanical properties.
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Affiliation(s)
- Hyoung-Ki Lee
- Department of Radiology, Mayo Clinic, Rochester, MN, United States of America
| | - Charles B Capron
- Mayo Clinic Graduate School of Biomedical Sciences, Rochester, United States of America
| | - Hsiao-Chuan Liu
- Department of Radiology, Mayo Clinic, Rochester, MN, United States of America
| | - Tuhin Roy
- North Carolina State University, Raleigh, NC, United States of America
| | - Murthy N Guddati
- North Carolina State University, Raleigh, NC, United States of America
| | - James F Greenleaf
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America
| | - Matthew W Urban
- Department of Radiology, Mayo Clinic, Rochester, MN, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America
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van den Bos-van de Steeg MGM, Fekkes S, Saris AECM, de Korte CL, Hansen HHG. In Vivo Comparison of Pulse Wave Velocity Estimation Based on Ultrafast Plane Wave Imaging and High-Frame-Rate Focused Transmissions. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:2335-2343. [PMID: 35999121 DOI: 10.1016/j.ultrasmedbio.2022.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/16/2022] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
Ultrasound-based local pulse wave velocity (PWV) estimation, as a measure of arterial stiffness, can be based on fast focused imaging (FFI) or plane wave imaging (PWI). This study was aimed at comparing the accuracy of in vivo PWV estimation using FFI and PWI. Ultrasound radiofrequency data of carotid arteries were acquired in 14 healthy volunteers (25-57 y) by executing the FFI (12 lines, 7200 Hz) and PWI (128 lines, 2000 Hz) methods consecutively. PWV was derived at two time-reference points, dicrotic notch (DN) and systolic foot (SF), for multiple pressure cycles by fitting a linear function through the positions of the peaks of low-pass filtered wall acceleration curves as a function of time. The accuracy of PWV estimation was determined for various cutoff frequencies (10-200 Hz). No statistically significant difference was observed between PWVs estimated by both approaches. The PWV and R2 at DN were higher, on average, than those at SF (PWV/R2: FFI SF 5.5/0.92, FFI DN 6.1/0.92; PWI SF 5.4/0.89, PWI DN 6.3/0.95). The use of cutoff frequencies between 40 and 80 Hz provided the most accurate PWVs. Both methods seemed equally suitable for use in clinical practice, although we have a preference for the PWV at DN given the higher R2 values.
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Affiliation(s)
- Melissa G M van den Bos-van de Steeg
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Medical Physics, Catharina Hospital, Eindhoven, The Netherlands
| | - Stein Fekkes
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne E C M Saris
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris L de Korte
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands; Physics of Fluid Group, TechMed Centrum, University of Twente, Enschede, The Netherlands.
| | - Hendrik H G Hansen
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands
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Nordenfur T, Caidahl K, Grishenkov D, Maksuti E, Marlevi D, Urban MW, Larsson M. Safety of arterial shear wave elastography- ex-vivoassessment of induced strain and strain rates. Biomed Phys Eng Express 2022; 8. [PMID: 35797069 DOI: 10.1088/2057-1976/ac7f39] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
Shear wave elastography (SWE) is a promising technique for characterizing carotid plaques and assessing local arterial stiffness. The mechanical stress to which the tissue is subjected during SWE using acoustic radiation force (ARF), leading to strain at a certain strain rate, is still relatively unknown. Because SWE is increasingly used for arterial applications where the mechanical stress could potentially lead to significant consequences, it is important to understand the risks of SWE- induced strain and strain rate. The aim of this study was to investigate the safety of SWE in terms of induced arterial strain and strain rateex-vivoand in a human carotid arteryin-vivo. SWE was performed on six porcine aortae as a model of the human carotid artery using different combinations of ARF push parameters (push voltage: 60/90 V, aperture width: f/1.0/1.5, push length: 100/150/200 μs) and distance to push position. The largest induced strain and strain rate were 1.46 % and 54 s-1(90 V, f/1.0, 200 μs), respectively. Moreover, the SWE-induced strains and strain rates increased with increasing push voltage, aperture, push length, and decreasing distance between the region of interest and the push. In the human carotid artery, the SWE-induced maximum strain was 0.06 % and the maximum strain rate was 1.58 s-1, compared with the maximum absolute strain and strain rate of 12.61 % and 5.12 s-1, respectively, induced by blood pressure variations in the cardiac cycle. Our results indicate thatex-vivoarterial SWE does not expose the artery to higher strain rate than normal blood pressure variations, and to strain one order of magnitude higher than normal blood pressure variations, at the push settings and distances from the region of interest used in this study.
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Affiliation(s)
- Tim Nordenfur
- Department of Biomedical Engineering and Health Systems, KTH, Kungliga Tekniska högskolan, Stockholm, 100 44, SWEDEN
| | - Kenneth Caidahl
- Department of Clinical Physiology, Karolinska University Hospital, Solnavägen 1, Solna, 171 77, SWEDEN
| | - Dmitry Grishenkov
- Department of Biomedical Engineering and Health Systems, KTH, KTH, Stockholm, 100 44, SWEDEN
| | - Elira Maksuti
- Dept. of Physiology and Pharmacology, Anaesthesiology and Intensive Care, Karolinska Institute, Solnavägen 1, Solna, 171 77, SWEDEN
| | - David Marlevi
- Dept. Molecular Medicine and Surgery, Karolinska Institute, Solnavägen 1, Solna, 171 77, SWEDEN
| | - Matthew W Urban
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, Minnesota, 55905, UNITED STATES
| | - Matilda Larsson
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, KTH, Stockholm, 100 44, SWEDEN
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Raj KV, Nabeel PM, Joseph J. Image-Free Fast Ultrasound for Measurement of Local Pulse Wave Velocity: In Vitro Validation and In Vivo Feasibility. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:2248-2256. [PMID: 35503839 DOI: 10.1109/tuffc.2022.3172265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Local pulse wave velocity (PWV), a metric of the target artery's stiffness, has been emerging in its clinical value and adoption. State-of-the-art ultrasound technologies used to evaluate local PWV based on pulse waves' features are sophisticated, non-real-time, and are not amenable for field and resource-constrained settings. In this work, we present an image-free ultrasound system to measure local PWV in real-time by employing a pair of ultrasound transducer elements. An in vitro study was performed on the arterial phantom to: 1) characterize the design aspects of the system and 2) validate its accuracy against beat-by-beat (invasive) local PWV measured by a reference dual-element catheter. Furthermore, a repeatability and reproducibility study on 33 subjects (21-52 years) investigated the in vivo measurement feasibility from the carotid artery. With the experimentally deduced optimal design (frame-rate =500 Hz, RF sampling rate =125 MHz, LPF cutoff =14 Hz, and order =4 ), the system yielded repeatable beat-to-beat measurements (variability =1.9 % and over 15 cycles) and achieved a high accuracy (root-mean-square-error =0.19 m/s and absolute-percentage-error =2.4 %) over a wide range of PWVs (2.7-11.4 m/s) from the phantom. Subsequently, on human subjects, the intra- and inter-operator PWV measurements were highly repeatable (intraclass correlation coefficient ). The system does not impose a demand for special processors with high-computational power while offering real-time feedback on acquisition and measurement quality and provides local PWV online. Future large population and animal studies are required to establish the device's clinical usability.
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Li GY, Jiang Y, Zheng Y, Xu W, Zhang Z, Cao Y. Arterial Stiffness Probed by Dynamic Ultrasound Elastography Characterizes Waveform of Blood Pressure. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:1510-1519. [PMID: 34995186 DOI: 10.1109/tmi.2022.3141613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The clinical and economic burdens of cardiovascular diseases pose a global challenge. Growing evidence suggests an early assessment of arterial stiffness can provide insights into the pathogenesis of cardiovascular diseases. However, it remains difficult to quantitatively characterize local arterial stiffness in vivo. Here we utilize guided axial waves continuously excited and detected by ultrasound to probe local blood pressures and mechanical properties of common carotid arteries simultaneously. In a pilot study of 17 healthy volunteers, we observe a ∼ 20 % variation in the group velocities of the guided axial waves (5.16 ± 0.55 m/s in systole and 4.31 ± 0.49 m/s in diastole) induced by the variation of the blood pressures. A linear relationship between the square of group velocity and blood pressure is revealed by the experiments and finite element analysis, which enables us to measure the waveform of the blood pressures by the group velocities. Furthermore, we propose a wavelet analysis-based method to extract the dispersion relations of the guided axial waves. We then determined the shear modulus by fitting the dispersion relations in diastole with the leaky Lamb wave model. The average shear modulus of all the volunteers is 166.3 ± 32.8 kPa. No gender differences are found. This study shows the group velocity and dispersion relation of the guided axial waves can be utilized to probe blood pressure and arterial stiffness locally in a noninvasive manner and thus promising for early diagnosis of cardiovascular diseases.
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Kiran V R, P M N, Manoj R, Shah MI, Sivaprakasam M, Joseph J. Phantom Assessment of an Image-free Ultrasound Technology for Online Local Pulse Wave Velocity Measurement. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5610-5613. [PMID: 34892396 DOI: 10.1109/embc46164.2021.9630499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cardiovascular community has started clinically adopting the assessment of local stiffness, contrary to the traditionally measured carotid-femoral pulse wave velocity (PWV). Though they offer higher reliability, ultrasound methods require advanced hardware and processing methods to perform real-time measurement of local PWV. This work presents a system and method to perform online PWV measurement in an automated manner. It is a fast image-free ultrasound technology that meets the methodological requirements necessary to measure small orders of local pulse transit, from which PWV is measured. The measurement accuracy and repeatability were assessed via phantom experiments, where the measured transit time-based PWV (PWVTT) was compared against the theoretically calculated PWV from Bramwell-Hill equation (PWVBH). The beat-to-beat variability in the measured PWVTT was within 3%. PWVTT values strongly correlated (r=0.98) with PWVBH, yielding a negligible bias of -0.01 m/s, mean error of 3%, and RMSE of 0.27 m/s. These pilot study results demonstrated the presented system's reliability in yielding online local PWV measurements.
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P M N, Kiran V R, Manoj R, V V A, Sivaprakasam M, Joseph J. High-Framerate A-Mode Ultrasound for Vascular Structural Assessments: In-Vivo Validation in a Porcine Model. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5602-5605. [PMID: 34892394 DOI: 10.1109/embc46164.2021.9629738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Capturing vascular dynamics using ultrasound at a high framerate provided a unique way to track time-dependent and transient physiologic events non-invasively. In this work, we present an A-model high-framerate (500 frames per second) image-free ultrasound system for monitoring vascular structural and material properties. It was developed based on our clinically validated ARTSENS® technology. Following in-vitro verification on arterial flow phantoms, its measurement accuracy and high-framerate data acquisition and processing were verified in-vivo on 2 anesthetized Sus scrofa swine. Measurements of the carotid artery (the luminal diameter, distension, and wall thickness) obtained using the high-framerate system were comparable to those provided by a clinical-grade reference ultrasound imaging device (absolute error < 4%, < 6.3%, and < 6.6%, respectively). Notably, the morphology of the arterial distension waveforms obtained at high-framerate depicted vital physiological fiduciary points compared to the low-framerate reference waveform. The compression-decompression pattern of the arterial wall was also captured with the high-framerate system, which is challenging with low-framerate ultrasound. Potential applications of these high temporal structural waveforms have also been discussed.
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Ilaria P, Mario M, Ilaria F. Advances in vascular anatomy and pathophysiology using high resolution and multiparametric sonography. J Vasc Access 2021; 22:1-8. [PMID: 34338066 PMCID: PMC8606621 DOI: 10.1177/11297298211020150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
B-mode and Color Doppler are the first-line imaging modalities in cardiovascular diseases. However, conventional ultrasound (US) provides a lower spatial and temporal resolution (70-100 frames per second) compared to ultrafast technology which acquires several thousand frames per second. Consequently, the multiparametric ultrafast platforms manage new imaging algorithms as high-frequency ultrasound, contrast-enhanced ultrasound, shear wave elastography, vector flow, and local pulse wave imaging. These advances allow better ultrasound performances, more detailed blood flow visualization and vessel walls' characterization, and many future applications for vascular viscoelastic properties evaluation.In this paper, we provide an overview of each new technique's principles and concepts and the real or potential applications of these modalities on the study of the artery and venous anatomy and pathophysiology of the upper limb before and after creating a native or prosthetic arterio-venous fistula. In particular, we focus on high-frequency ultrasound that could predict cannulation readiness and its potential role in the venous valvular status evaluation before vascular access creation; on contrast-enhanced ultrasound that could improve the peri-operative imaging evaluation during US-guided angioplasty; on shear wave elastography and local pulse wave imaging that could evaluate preoperative vessels stiffness and their potential predictive role in vascular access failure; on vector flow imaging that could better characterize the different components of the vascular access complex flow.
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Affiliation(s)
- Petrucci Ilaria
- Institute of Life Sciences, S. Anna School of Advanced Studies, Pisa, Italy
| | - Meola Mario
- Institute of Life Sciences, S. Anna School of Advanced Studies, Department of Internal Medicine, University of Pisa, Pisa, Italy
| | - Fiorina Ilaria
- Radiodiagnostic and Interventional Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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14
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Karageorgos GM, Apostolakis IZ, Nauleau P, Gatti V, Weber R, Kemper P, Konofagou EE. Pulse Wave Imaging Coupled With Vector Flow Mapping: A Phantom, Simulation, and In Vivo Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:2516-2531. [PMID: 33950838 PMCID: PMC8477914 DOI: 10.1109/tuffc.2021.3074113] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Pulse wave imaging (PWI) is an ultrasound imaging modality that estimates the wall stiffness of an imaged arterial segment by tracking the pulse wave propagation. The aim of the present study is to integrate PWI with vector flow imaging, enabling simultaneous and co-localized mapping of vessel wall mechanical properties and 2-D flow patterns. Two vector flow imaging techniques were implemented using the PWI acquisition sequence: 1) multiangle vector Doppler and 2) a cross-correlation-based vector flow imaging (CC VFI) method. The two vector flow imaging techniques were evaluated in vitro using a vessel phantom with an embedded plaque, along with spatially registered fluid structure interaction (FSI) simulations with the same geometry and inlet flow as the phantom setup. The flow magnitude and vector direction obtained through simulations and phantom experiments were compared in a prestenotic and stenotic segment of the phantom and at five different time frames. In most comparisons, CC VFI provided significantly lower bias or precision than the vector Doppler method ( ) indicating better performance. In addition, the proposed technique was applied to the carotid arteries of nonatherosclerotic subjects of different ages to investigate the relationship between PWI-derived compliance of the arterial wall and flow velocity in vivo. Spearman's rank-order test revealed positive correlation between compliance and peak flow velocity magnitude ( rs = 0.90 and ), while significantly lower compliance ( ) and lower peak flow velocity magnitude ( ) were determined in older (54-73 y.o.) compared with young (24-32 y.o.) subjects. Finally, initial feasibility was shown in an atherosclerotic common carotid artery in vivo. The proposed imaging modality successfully provided information on blood flow patterns and arterial wall stiffness and is expected to provide additional insight in studying carotid artery biomechanics, as well as aid in carotid artery disease diagnosis and monitoring.
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Roy T, Urban M, Xu Y, Greenleaf J, Guddati MN. Multimodal guided wave inversion for arterial stiffness: methodology and validation in phantoms. Phys Med Biol 2021; 66. [PMID: 34061042 DOI: 10.1088/1361-6560/ac01b7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 05/14/2021] [Indexed: 11/12/2022]
Abstract
Arterial stiffness is an important biomarker for many cardiovascular diseases. Shear wave elastography is a recent technique aimed at estimating local arterial stiffness using guided wave inversion (GWI), i.e. matching the computed and measured wave dispersion. This paper develops and validates a new GWI approach by synthesizing various recent observations and algorithms: (a) refinements to signal processing to obtain more accurate experimental dispersion curves; (b) an efficient forward model to compute theoretical dispersion curves for immersed, incompressible cylindrical waveguides; (c) an optimization framework based on the recent observation that the measured dispersion curve is multimodal, i.e. it matches for not one but two different wave modes in two different frequency ranges. The resulting inversion approach is validated using extensive experimental data from rubber tube phantoms, not only for modulus estimation but also to simultaneously estimate modulus and wall thickness. The observations indicate that the modulus estimates are best performed with the information on wall thickness. The approach, which takes less than half a minute to run, is shown to be accurate, with the modulus estimated with less than 4% error for 70% of the experiments.
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Affiliation(s)
- Tuhin Roy
- Department of Civil Engineering, North Carolina State University, Raleigh, NC, United States of America
| | - Matthew Urban
- Department of Radiology, Mayo Clinic, Rochester, MN, United States of America.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America
| | - Yingzheng Xu
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, United States of America
| | - James Greenleaf
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America
| | - Murthy N Guddati
- Department of Civil Engineering, North Carolina State University, Raleigh, NC, United States of America
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16
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From Anatomy to Functional and Molecular Biomarker Imaging and Therapy: Ultrasound Is Safe, Ultrafast, Portable, and Inexpensive. Invest Radiol 2021; 55:559-572. [PMID: 32776766 DOI: 10.1097/rli.0000000000000675] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Ultrasound is the most widely used medical imaging modality worldwide. It is abundant, extremely safe, portable, and inexpensive. In this review, we consider some of the current development trends for ultrasound imaging, which build upon its current strength and the popularity it experiences among medical imaging professional users.Ultrasound has rapidly expanded beyond traditional radiology departments and cardiology practices. Computing power and data processing capabilities of commonly available electronics put ultrasound systems in a lab coat pocket or on a user's mobile phone. Taking advantage of new contributions and discoveries in ultrasound physics, signal processing algorithms, and electronics, the performance of ultrasound systems and transducers have progressed in terms of them becoming smaller, with higher imaging performance, and having lower cost. Ultrasound operates in real time, now at ultrafast speeds; kilohertz frame rates are already achieved by many systems.Ultrasound has progressed beyond anatomical imaging and monitoring blood flow in large vessels. With clinical approval of ultrasound contrast agents (gas-filled microbubbles) that are administered in the bloodstream, tissue perfusion studies are now routine. Through the use of modern ultrasound pulse sequences, individual microbubbles, with subpicogram mass, can be detected and observed in real time, many centimeters deep in the body. Ultrasound imaging has broken the wavelength barrier; by tracking positions of microbubbles within the vasculature, superresolution imaging has been made possible. Ultrasound can now trace the smallest vessels and capillaries, and obtain blood velocity data in those vessels.Molecular ultrasound imaging has now moved closer to clinic; the use of microbubbles with a specific affinity to endothelial biomarkers allows selective accumulation and retention of ultrasound contrast in the areas of ischemic injury, inflammation, or neoangiogenesis. This will aid in noninvasive molecular imaging and may provide additional help with real-time guidance of biopsy, surgery, and ablation procedures.The ultrasound field can be tightly focused inside the body, many centimeters deep, with millimeter precision, and ablate lesions by energy deposition, with thermal or mechanical bioeffects. Some of such treatments are already in clinical use, with more indications progressing through the clinical trial stage. In conjunction with intravascular microbubbles, focused ultrasound can be used for tissue-specific drug delivery; localized triggered release of sequestered drugs from particles in the bloodstream may take time to get to clinic. A combination of intravascular microbubbles with circulating drug and low-power ultrasound allows transient opening of vascular endothelial barriers, including blood-brain barrier; this approach has reached clinical trial stage. Therefore, the drugs that normally would not be getting to the target tissue in the brain will now have an opportunity to produce therapeutic efficacy.Overall, medical ultrasound is developing at a brisk rate, even in an environment where other imaging modalities are also advancing rapidly and may be considered more lucrative. With all the current advances that we discuss, and many more to come, ultrasound may help solve many problems that modern medicine is facing.
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Gatti V, Nauleau P, Karageorgos GM, Shim JJ, Ateshian GA, Konofagou EE. Modeling Pulse Wave Propagation Through a Stenotic Artery With Fluid Structure Interaction: A Validation Study Using Ultrasound Pulse Wave Imaging. J Biomech Eng 2021; 143:031005. [PMID: 33030208 PMCID: PMC7872000 DOI: 10.1115/1.4048708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/01/2020] [Indexed: 11/08/2022]
Abstract
Pulse wave imaging (PWI) is an ultrasound-based method that allows spatiotemporal mapping of the arterial pulse wave propagation, from which the local pulse wave velocity (PWV) can be derived. Recent reports indicate that PWI can help the assessment of atherosclerotic plaque composition and mechanical properties. However, the effect of the atherosclerotic plaque's geometry and mechanics on the arterial wall distension and local PWV remains unclear. In this study, we investigated the accuracy of a finite element (FE) fluid-structure interaction (FSI) approach to predict the velocity of a pulse wave propagating through a stenotic artery with an asymmetrical plaque, as quantified with PWI method. Experiments were designed to compare FE-FSI modeling of the pulse wave propagation through a stenotic artery against PWI obtained with manufactured phantom arteries made of polyvinyl alcohol (PVA) material. FSI-generated spatiotemporal maps were used to estimate PWV at the plaque region and compared it to the experimental results. Velocity of the pulse wave propagation and magnitude of the wall distension were correctly predicted with the FE analysis. In addition, findings indicate that a plaque with a high degree of stenosis (>70%) attenuates the propagation of the pulse pressure wave. Results of this study support the validity of the FE-FSI methods to investigate the effect of arterial wall structural and mechanical properties on the pulse wave propagation. This modeling method can help to guide the optimization of PWI to characterize plaque properties and substantiate clinical findings.
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Affiliation(s)
- Vittorio Gatti
- Department of Biomedical Engineering, Columbia University, New York, NY 10027
| | - Pierre Nauleau
- Department of Biomedical Engineering, Columbia University, New York, NY 10027
| | | | - Jay J. Shim
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Gerard A. Ateshian
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Elisa E. Konofagou
- Department of Biomedical Engineering, Columbia University, New York, NY 10027; Department of Radiology, Columbia University, 351 Engineering Terrace, Mail Code 8904, New York, NY 10027
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18
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Perrot V, Ekroll IK, Avdal J, Saxhaug LM, Dalen H, Vray D, Lovstakken L, Liebgott H. Translation of Simultaneous Vessel Wall Motion and Vectorial Blood Flow Imaging in Healthy and Diseased Carotids to the Clinic: A Pilot Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:558-569. [PMID: 32776877 DOI: 10.1109/tuffc.2020.3015340] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study aims to investigate the clinical feasibility of simultaneous extraction of vessel wall motion and vectorial blood flow at high frame rates for both extraction of clinical markers and visual inspection. If available in the clinic, such a technique would allow a better estimation of plaque vulnerability and improved evaluation of the overall arterial health of patients. In this study, both healthy volunteers and patients were recruited and scanned using a planewave acquisition scheme that provided a data set of 43 carotid recordings in total. The vessel wall motion was extracted based on the complex autocorrelation of the signals received, while the vector flow was extracted using the transverse oscillation technique. Wall motion and vector flow were extracted at high frame rates, which allowed for a visual appreciation of tissue movement and blood flow simultaneously. Several clinical markers were extracted, and visual inspections of the wall motion and flow were conducted. From all the potential markers, young healthy volunteers had smaller artery diameter (7.72 mm) compared with diseased patients (9.56 mm) ( p -value ≤ 0.001), 66% of diseased patients had backflow compared with less than 10% for the other patients ( p -value ≤ 0.05), a carotid with a pulse wave velocity extracted from the wall velocity greater than 7 m/s was always a diseased vessel, and the peak wall shear rate decreased as the risk increases. Based on both the pathological markers and the visual inspection of tissue motion and vector flow, we conclude that the clinical feasibility of this approach is demonstrated. Larger and more disease-specific studies using such an approach will lead to better understanding and evaluation of vessels, which can translate to future use in the clinic.
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19
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Zhang J, He Q, Xiao Y, Zheng H, Wang C, Luo J. Ultrasound image reconstruction from plane wave radio-frequency data by self-supervised deep neural network. Med Image Anal 2021; 70:102018. [PMID: 33711740 DOI: 10.1016/j.media.2021.102018] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/20/2021] [Accepted: 02/19/2021] [Indexed: 12/19/2022]
Abstract
Image reconstruction from radio-frequency (RF) data is crucial for ultrafast plane wave ultrasound (PWUS) imaging. Compared with the traditional delay-and-sum (DAS) method based on relatively imprecise assumptions, sparse regularization (SR) method directly solves the inverse problem of image reconstruction and has presented significant improvement in the image quality when the frame rate remains high. However, the computational complexity of SR is too high for practical implementation, which is inherently associated with its iterative process. In this work, a deep neural network (DNN), which is trained with an incorporated loss function including sparse regularization terms, is proposed to reconstruct PWUS images from RF data with significantly reduced computational time. It is remarkable that, a self-supervised learning scheme, in which the RF data are utilized as both the inputs and the labels during the training process, is employed to overcome the lack of the "ideal" ultrasound images as the labels for DNN. In addition, it has been also verified that the trained network can be used on the RF data obtained with steered plane waves (PWs), and thus the image quality can be further improved with coherent compounding. Using simulation data, the proposed method has significantly shorter reconstruction time (∼10 ms) than the conventional SR method (∼1-5 mins), with comparable spatial resolution and 1.5-dB higher contrast-to-noise ratio (CNR). Besides, the proposed method with single PW can achieve higher CNR than DAS with 75 PWs in reconstruction of in-vivo images of human carotid arteries.
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Affiliation(s)
- Jingke Zhang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Qiong He
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China; Tsinghua-Peking Joint Center for Life Sciences Department, Tsinghua University, Beijing 100084, China
| | - Yang Xiao
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Congzhi Wang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; National Innovation Center for Advanced Medical Devices, Shenzhen 518055, China.
| | - Jianwen Luo
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China.
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20
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Heidari Pahlavian S, Cen SY, Bi X, Wang DJJ, Chui HC, Yan L. Assessment of carotid stiffness by measuring carotid pulse wave velocity using a single-slice oblique-sagittal phase-contrast MRI. Magn Reson Med 2021; 86:442-455. [PMID: 33543788 DOI: 10.1002/mrm.28677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 11/06/2022]
Abstract
PURPOSE Increased arterial stiffness has been shown to be one of the earliest markers of cerebrovascular dysfunction. As a surrogate marker of arterial stiffness, pulse wave velocity (PWV) quantifications are generally carried out on central and peripheral arteries. The purpose of this study was to develop and evaluate an MRI approach to assess carotid stiffness by measuring carotid PWV (cPWV) using a fast oblique-sagittal phase-contrast MRI sequence. METHODS In 29 volunteers, a single-slice oblique-sagittal phase-contrast MRI sequence with retrospective cardiac gating was used to quantify blood velocity waveforms along a vessel segment covering the common carotid artery (CCA) and the internal carotid artery (ICA). The CCA-ICA segment length was measured from a region of interest selected on the magnitude image. Phase-contrast MRI-measured velocities were also used to quantify the ICA pulsatility index along with cPWV quantification. RESULTS The mean value of cPWV calculated using the middle upslope area algorithm was 2.86 ± 0.71 and 3.97 ± 1.14 m/s in young and elderly subjects, respectively. Oblique-sagittal phase-contrast MRI-derived cPWV measurements showed excellent intrascan and interscan repeatability. cPWV and ICA pulsatility index were significantly greater in older subjects compared to those in the young subjects (P < .01 and P = .01, respectively). Also, increased cPWV values were associated with elevated systolic blood pressure (β = 0.05, P = .03). CONCLUSION This study demonstrated that oblique-sagittal phase-contrast MRI is a feasible technique for the quantification of both cPWV and ICA pulsatility index and showed their potential utility in evaluating cerebroarterial aging and age-related neurovascular disorders.
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Affiliation(s)
- Soroush Heidari Pahlavian
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Steven Yong Cen
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Xiaoming Bi
- Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - Danny J J Wang
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Helena Chang Chui
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Lirong Yan
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
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21
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Wang Z, Li W, Liu W, Tian J. Gender is a determinant of carotid artery stiffness independent of age and blood pressure. Br J Radiol 2021; 94:20200796. [PMID: 33476176 DOI: 10.1259/bjr.20200796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To identify the gender-specific differences in carotid artery structural and stiffening parameters by radiofrequency ultrasound (RFU) with an automatic arterial stiffness analyzing system. METHODS Seventy-two consecutive individuals (32 males and 40 females, age range from 36 to 62 years) with no history of significant cardiovascular diseases or carotid artery plaques were enrolled between September and December 2017. Quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) parameters were automatically computed, including pulse wave velocity (PWV), vascular distension, compliance coefficient (CC), distensibility coefficient (DC), stiffness index α and β, augmentation pressure (AP), and augmentation index (AIx). Those parameters were compared between males and females. Multiple linear regression analysis was performed to assess the independent association between gender and RFU parameters. RESULTS The mean age had no difference between males and females (47.8 ± 3.3 vs 50.0 ± 8.5 years, p = 0.19). Females had higher systolic blood pressure (134.53 ± 9.65 vs 127.78 ± 6.12 mm Hg) and diastolic blood pressure (85.83 ± 3.94 vs 78.03 ± 5.22 mm Hg), greater carotid QIMT (598.73 ± 72.16 vs 550.84 ± 29.37 µm), advanced PWV (8.08 ± 1.60 vs 6.24 ± 0.70 m/s), higher stiffness index α (6.21 ± 1.94 vs 3.95 ± 0.78) and β (9.43 ± 3.17 vs 6.38 ± 0.78), higher AP (6.68 ± 2.24 vs 3.64 ± 1.22 mm Hg) and AIx (7.42 ± 2.08 vs 4.69 ± 1.26%), all p < 0.001. Multiple linear regression analysis demonstrated gender was independently associated with carotid structural and elastic parameters. CONCLUSION Gender independently impacts carotid structure and function, with females more vulnerable to the progression of arterial aging. Awareness of the gender differences on the risk stratification of carotid artery disease will benefit reliable assessments and specific management recommendations in clinical practice. ADVANCES IN KNOWLEDGE (1) RFU provides an μm-unit quality IMT measurement and multiple quality arterial stiffness parameters. (2) Gender is an independent determinant in both the arterial structural and elastic aspects, with females of stiffer arteries in low CVD risk individuals.
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Affiliation(s)
- Zhenzhen Wang
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Li
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Liu
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiawei Tian
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
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22
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Seo J, Lee HS, Sodini CG. Non-Invasive Evaluation of a Carotid Arterial Pressure Waveform Using Motion-Tolerant Ultrasound Measurements During the Valsalva Maneuver. IEEE J Biomed Health Inform 2021; 25:163-174. [PMID: 32750903 DOI: 10.1109/jbhi.2020.2995344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This work details the non-invasive evaluation of a carotid arterial blood pressure (ABP) waveform during the Valsalva maneuver. Unfocused and wide acoustic beams are insonated on the carotid artery to achieve motion-tolerant measurements with a simple two-element ultrasound scanner. Arterial flow and distension waveforms are reliably estimated from spectral Doppler and M-mode ultrasound images whose qualities are consistently maintained in different phases of the maneuver despite possible displacements of the artery. A local pulse wave velocity is estimated using a flow-area method, and it is then combined with the distension waveform to produce the ABP waveform. Human subject validation on seven healthy subjects shows that the bias in pulse pressure estimates across subjects is 0.47 ± 13.1 mmHg. The average root mean square deviations of the ultrasonically measured waveform across subjects is 10.1 ± 2.43 mmHg, excluding the strain phase of the Valsalva maneuver, and 17.7 ± 6.30 mmHg in all phases. The mean correlation coefficient between the ultrasonically measured and reference waveform is calculated to be 0.92 ± 0.04 across subjects. Detailed morphological features and their changes across different phases are observed as reported. This uninterrupted central ABP waveform monitoring under hemodynamics changes supports the idea of a novel stress test to evaluate the health and dynamics of the cardiovascular system at a spot check in clinical settings.
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23
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Feiger B, Adebiyi A, Randles A. Multiscale modeling of blood flow to assess neurological complications in patients supported by venoarterial extracorporeal membrane oxygenation. Comput Biol Med 2020; 129:104155. [PMID: 33333365 DOI: 10.1016/j.compbiomed.2020.104155] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/06/2020] [Accepted: 11/23/2020] [Indexed: 12/28/2022]
Abstract
Computational blood flow models in large arteries elucidate valuable relationships between cardiovascular diseases and hemodynamics, leading to improvements in treatment planning and clinical decision making. One such application with potential to benefit from simulation is venoarterial extracorporeal membrane oxygenation (VA-ECMO), a support system for patients with cardiopulmonary failure. VA-ECMO patients develop high rates of neurological complications, partially due to abnormal blood flow throughout the vasculature from the VA-ECMO system. To better understand these hemodynamic changes, it is important to resolve complex local flow parameters derived from three-dimensional (3D) fluid dynamics while also capturing the impact of VA-ECMO support throughout the systemic arterial system. As high-resolution 3D simulations of the arterial network remain computationally expensive and intractable for large studies, a validated, multiscale model is needed to compute both global effects and high-fidelity local hemodynamics. In this work, we developed and demonstrated a framework to model hemodynamics in VA-ECMO patients using coupled 3D and one-dimensional (1D) models (1D→3D). We demonstrated the ability of these multiscale models to simulate complex flow patterns in specific regions of interest while capturing bulk flow throughout the systemic arterial system. We compared 1D, 3D, and 1D→3D coupled models and found that multiscale models were able to sufficiently capture both global and local hemodynamics in the cerebral arteries and aorta in VA-ECMO patients. This study is the first to develop and compare 1D, 3D, and 1D→ 3D coupled models on the larger arterial system scale in VA-ECMO patients, with potential use for other large scale applications.
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Affiliation(s)
- Bradley Feiger
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Adebayo Adebiyi
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Amanda Randles
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.
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24
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A Non-invasive Method for Determining Biomechanical Properties of the Internal Carotid Artery. Ing Rech Biomed 2020. [DOI: 10.1016/j.irbm.2019.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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25
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Abstract
Despite the wide recognition of larger artery stiffness as a highly clinically relevant and independent prognostic biomarker, it has yet be incorporated into routine clinical practice and to take a more prominent position in clinical guidelines. An important reason may be the plethora of methods and devices claiming to measure arterial stiffness in humans. This brief review provides a concise overview of methods in use, indicating strengths and weaknesses. We classified and graded methods, highly weighing their scrutiny and purity in quantifying arterial stiffness, rather than focusing on their ease of application or the level at which methods have demonstrated their prognostic and diagnostic potential.
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Affiliation(s)
- Patrick Segers
- From the Biofluid, Tissue, and Solid Mechanics for Medical Applications, IBiTech Ghent (P.S.), University of Ghent, Belgium
| | - Ernst R Rietzschel
- Departments of Cardiology, Biobanking, and Cardiovascular Epidemiology (E.R.R.), University of Ghent, Belgium
- Ghent University Hospital, Belgium (E.R.R.)
| | - Julio A Chirinos
- Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, PA (J.A.C.)
- University of Pennsylvania Perelman School of Medicine, PA (J.A.C.)
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26
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Deng L, Zhang Y, Chen Z, Zhao Z, Zhang K, Wu J. Regional Upstroke Tracking for Transit Time Detection to Improve the Ultrasound-Based Local PWV Estimation in Carotid Arteries. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2020; 67:691-702. [PMID: 31714222 DOI: 10.1109/tuffc.2019.2951922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pulse wave velocity (PWV) is the most important index for quantifying the elasticity of an artery. The accurate estimation of the local PWV is of great relevance to the early diagnosis and effective prevention of arterial stiffness. In ultrasonic transit time-based local PWV estimation, the locations of time fiduciary point (TFP) in the upstrokes of the propagating pulse waves (PWs) are inconsistent because of the reflected waves and ultrasonic noise. In this study, a regional upstroke tracking (RUT) approach that involved identifying the most similar TFP-centered region in the upstrokes is proposed to detect the time delay for improving the local PWV estimation. Five RUT algorithms with different tracking points are assessed via simulation and clinical experiments. To quantitatively evaluate the RUT algorithms, the normalized root-mean-squared errors and standard deviations of the estimated PWVs are calculated using an ultrasound simulation model. The reproducibility of the five RUT algorithms based on 30 human subjects is also evaluated using the Bland-Altman analysis and coefficient of variation (CV). The obtained results show that the RUT algorithms with only three tracking points provide greater accuracy, precision, and reproducibility for the local PWV estimation than the TFP methods. Compared with the TFP methods, the RUT algorithms reduce the mean errors from 12.23% ± 3.10% to 7.13% ± 2.31%, as well as the CVs from 21.76% to 13.39%. In conclusion, the proposed RUT algorithms are superior to the TFP methods for local carotid PWV estimation.
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Tang CJ, Lee PY, Chuang YH, Huang CC. Measurement of local pulse wave velocity for carotid artery by using an ultrasound-based method. ULTRASONICS 2020; 102:106064. [PMID: 31955815 DOI: 10.1016/j.ultras.2020.106064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/11/2019] [Accepted: 12/09/2019] [Indexed: 06/10/2023]
Abstract
Currently, pulse wave velocity (PWV) is an important physical index for characterizing the mechanical properties of arteries. Carotid-femoral PWV (cfPWV) is a clinically-approved parameter for evaluating the cardiovascular risk and therapeutic efficacy. However, cfPWV only provides global information about vessel properties. Many recent studies have indicated that local PWV measurements provide precise evaluation of artery conditions. Here, an ultrasound (US) method based on a novel vessel displacement waveform correction, is proposed for improving the accuracy of local carotid PWV measurement. A programmable US device and a commercial array transducer were used, which allow a user to excite transducer and receive US signals arbitrarily with different beam settings. The local PWV measurement accuracy was verified using a phantom. The number of US beams used for PWV measurements was also considered, which indicates that eight elements is the acceptable setting. Subsequently, local carotid PWV and cfPWV were measured in 35 healthy human subjects (age: 21.9 ± 2.4 years) by using the US method and SphygmoCor device, respectively. The cfPWV and local carotid PWV were 6.65 ± 0.74 and 4.63 ± 0.57 m/s, respectively. A good linear correlation was observed between the two aforementioned methods (r = 0.8) for the subjects. All the results indicated that when few US beams were used, the proposed method exhibited a reliable measurement of local PWV.
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Affiliation(s)
- Chieh-Ju Tang
- Department of Biomedical Engineering, National Cheng Kung University, Taiwan
| | - Po-Yang Lee
- Department of Biomedical Engineering, National Cheng Kung University, Taiwan
| | - Yi-Hsiang Chuang
- Department of Biomedical Engineering, National Cheng Kung University, Taiwan
| | - Chih-Chung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Taiwan.
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Salles S, Lovstakken L, Aase SA, Bjastad TG, Torp H. Clutter Filter Wave Imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:1444-1452. [PMID: 31226072 DOI: 10.1109/tuffc.2019.2923710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The elastic properties of human tissue can be evaluated through the study of mechanical wave propagation captured using high frame rate ultrasound imaging. Methods such as block-matching or phase-based motion estimation have been used to estimate the displacement induced by the mechanical waves. In this paper, a new method for detecting mechanical wave propagation without motion estimation is presented, where the motion of interest is accentuated by an appropriate clutter filter. Thus, the mechanical wave propagation will directly appear as bands of the attenuated signal moving in the B-mode sequence and corresponding anatomical M-mode images. While only the locality of tissue velocity induced by the mechanical wave is detected, it is shown that the method is more sensitive to subtle tissue displacements when compared to motion estimation techniques. The technique was evaluated for the propagation of the pulse wave in a carotid artery, mechanical waves on the left ventricle, and shear waves induced by radiation force on a tissue-mimicking phantom. The results were compared to tissue Doppler imaging (TDI) and demonstrated that clutter filter wave imaging (CFWI) was able to detect the mechanical wave propagating in tissue with a relative temporal and spatial resolution 30% higher and a relative consistency 40% higher than TDI. The results showed that CFWI was able to detect mechanical waves with a relative frequency content 40% higher than TDI in a shear wave imaging experiment.
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Sakalauskas A, Jurkonis R, Gelman S, Lukoševičius A, Kupčinskas L. Investigation of Radiofrequency Ultrasound-Based Fibrotic Tissue Strain Imaging Method Employing Endogenous Motion. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2315-2327. [PMID: 30609066 DOI: 10.1002/jum.14925] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 11/13/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The paper presents the results of an initial clinical study, which were obtained using the strain elastography imaging method based on radio frequency ultrasound signal analysis. METHODS The technique employs endogenous motion of the liver induced by beating heart and vascular pulsatility as an excitation source of tissue microdisplacement. The potential for fibrotic tissue characterization was demonstrated using a clinical data set of radio frequency ultrasound signals (23 healthy controls, 21 subjects with hepatitis, and 16 subjects with liver cirrhosis). Parametric maps, which represent the tissue strain, were derived from the gradient of the integrated spectral coefficient parameter, and correlations with the stage of liver disease were evaluated. Average endogenous strain derived from the gradient of the integrated spectral coefficient parameter and variability (standard deviation) of the strain were evaluated in the rectangular regions of interest (sizes, 1 × 1 and 2 × 2 cm) defined by the observer. The assessment of strain was performed in different frequency subbands of endogenous motion (0-10 Hz and 10-20 Hz). RESULTS The best distinction between the groups was observed for the average strain derived from the gradient of the integrated spectral coefficient parameter: the controls, 13.30 ± 6.62; hepatitis, 7.12 ± 7.45; cirrhosis, 3.95 ± 2.44 μm/cm (region of interest, 1 × 1 cm; frequency subband 0-10 Hz), and 10.48 ± 6.02, 8.27 ± 5.41, 3.89 ± 2.07 μm/cm, respectively (2 × 2 cm, 0-10 Hz). CONCLUSION The investigated strain parameters showed statistically significant differences (P < .001) for the different stages of liver fibrosis in most of the cases and proved this method to be feasible.
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Affiliation(s)
- Andrius Sakalauskas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Rytis Jurkonis
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Sigita Gelman
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Arūnas Lukoševičius
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Limas Kupčinskas
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Nabeel PM, Kiran VR, Joseph J, Abhidev VV, Sivaprakasam M. Local Pulse Wave Velocity: Theory, Methods, Advancements, and Clinical Applications. IEEE Rev Biomed Eng 2019; 13:74-112. [PMID: 31369386 DOI: 10.1109/rbme.2019.2931587] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Local pulse wave velocity (PWV) is evolving as one of the important determinants of arterial hemodynamics, localized vessel stiffening associated with several pathologies, and a host of other cardiovascular events. Although PWV was introduced over a century ago, only in recent decades, due to various technological advancements, has emphasis been directed toward its measurement from a single arterial section or from piecewise segments of a target arterial section. This emerging worldwide trend in the exploration of instrumental solutions for local PWV measurement has produced several invasive and noninvasive methods. As of yet, however, a univocal opinion on the ideal measurement method has not emerged. Neither have there been extensive comparative studies on the accuracy of the available methods. Recognizing this reality, makes apparent the need to establish guideline-recommended standards for the measurement methods and reference values, without which clinical application cannot be pursued. This paper enumerates all major local PWV measurement methods while pinpointing their salient methodological considerations and emphasizing the necessity of global standardization. Further, a summary of the advancements in measuring modalities and clinical applications is provided. Additionally, a detailed discussion on the minimally explored concept of incremental local PWV is presented along with suggestions of future research questions.
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Wang Y, Li H, Guo Y, Lee WN. Bidirectional Ultrasound Elastographic Imaging Framework for Non-invasive Assessment of the Non-linear Behavior of a Physiologically Pressurized Artery. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1184-1196. [PMID: 30876671 DOI: 10.1016/j.ultrasmedbio.2019.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 01/10/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
Studies of non-destructive bidirectional ultrasound assessment of non-linear mechanical behavior of the artery are scarce in the literature. We hereby propose derivation of a strain-shear modulus relationship as a new graphical diagnostic index using an ultrasound elastographic imaging framework, which encompasses our in-house bidirectional vascular guided wave imaging (VGWI) and ultrasound strain imaging (USI). This framework is used to assess arterial non-linearity in two orthogonal (i.e., longitudinal and circumferential) directions in the absence of non-invasive pressure measurement. Bidirectional VGWI estimates longitudinal (μL) and transverse (μT) shear moduli, whereas USI estimates radial strain (ɛr). Vessel-mimicking phantoms (with and without longitudinal pre-stretch) and in vitro porcine aortas under static and/or dynamic physiologic intraluminal pressure loads were examined. ɛr was found to be a suitable alternative to intraluminal pressure for representation of cyclic loading on the artery wall. Results revealed that μT values of all samples examined increased non-linearly with εr magnitude and more drastically than μL, whereas μL values of only the pre-stretched phantoms and aortas increased with ɛr magnitude. As a new graphical representation of arterial non-linearity and function, strain-shear modulus loops derived by the proposed framework over two consecutive dynamic loading cycles differentiated sample pre-conditions and corroborated direction-dependent non-linear mechanical behaviors of the aorta with high estimation repeatability.
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Affiliation(s)
- Yahua Wang
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - He Li
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - Yuexin Guo
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - Wei-Ning Lee
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong; Medical Engineering Programme, University of Hong Kong, Hong Kong.
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Asma Ayadi A, Wassila Sahtout B, Olivier Balédent C. A novel non-invasive method for estimating biomechanical properties of the internal carotid. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A. Asma Ayadi
- Laboratory of Biophysics and Medical Technology, Higher Institute of Medical Technology of Tunis, Tunis Elmanar University, Tunis, Tunisia
| | - B. Wassila Sahtout
- Laboratory of Biophysics and Medical Technology, Higher Institute of Biotechnology of Sfax, Sfax University, Sfax, Tunisia
| | - C. Olivier Balédent
- Department of Imaging and Biophysics, University of Picardie Jules Verne, CHU Amiens, Amiens, France
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El Jalbout R, Cloutier G, Roy-Cardinal MH, Henderson M, Levy E, Lapierre C, Soulez G, Dubois J. The value of non-invasive vascular elastography (NIVE) in detecting early vascular changes in overweight and obese children. Eur Radiol 2019; 29:3854-3861. [DOI: 10.1007/s00330-019-06051-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/03/2019] [Accepted: 01/30/2019] [Indexed: 10/27/2022]
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Li RX, Apostolakis IZ, Kemper P, McGarry MDJ, Ip A, Connolly ES, McKinsey JF, Konofagou EE. Pulse Wave Imaging in Carotid Artery Stenosis Human Patients in Vivo. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:353-366. [PMID: 30442386 PMCID: PMC6375685 DOI: 10.1016/j.ultrasmedbio.2018.07.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 06/29/2018] [Accepted: 07/16/2018] [Indexed: 05/03/2023]
Abstract
Carotid stenosis involves narrowing of the lumen in the carotid artery potentially leading to a stroke, which is the third leading cause of death in the United States. Several recent investigations have found that plaque structure and composition may represent a more direct biomarker of plaque rupture risk compared with the degree of stenosis. In this study, pulse wave imaging was applied in 111 (n = 11, N = 13 plaques) patients diagnosed with moderate (>50%) to severe (>80%) carotid artery stenosis to investigate the feasibility of characterizing plaque properties based on the pulse wave-induced arterial wall dynamics captured by pulse wave imaging. Five (n = 5 patients, N = 20 measurements) healthy volunteers were also imaged as a control group. Both conventional and high-frame-rate plane wave radiofrequency imaging sequences were used to generate piecewise maps of the pulse wave velocity (PWV) at a single depth along stenotic carotid segments, as well as intra-plaque PWV mapping at multiple depths. Intra-plaque cumulative displacement and strain maps were also calculated for each plaque region. The Bramwell-Hill equation was used to estimate the compliance of the plaque regions based on the PWV and diameter. Qualitatively, wave convergence, elevated PWV and decreased cumulative displacement around and/or within regions of atherosclerotic plaque were observed and may serve as biomarkers for plaque characterization. Intra-plaque mapping revealed the potential to capture wave reflections between calcified inclusions and differentiate stable (i.e., calcified) from vulnerable (i.e., lipid) plaque components based on the intra-plaque PWV and cumulative strain. Quantitatively, one-way analysis of variance indicated that the pulse wave-induced cumulative strain was significantly lower (p < 0.01) in the moderately and severely calcified plaques compared with the normal controls. As expected, compliance was also significantly lower in the severely calcified plaques regions compared with the normal controls (p < 0.01). The results from this pilot study indicated the potential of pulse wave imaging coupled with strain imaging to differentiate plaques of varying stiffness, location and composition. Such findings may serve as valuable information to compensate for the limitations of currently used methods for the assessment of stroke risk.
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Affiliation(s)
- Ronny X Li
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Iason Z Apostolakis
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Paul Kemper
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Matthew D J McGarry
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Ada Ip
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Edward S Connolly
- Department of Neurologic Surgery, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York, USA
| | - James F McKinsey
- Division of Vascular Surgery and Endovascular Interventions, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York, USA
| | - Elisa E Konofagou
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA; Department of Radiology, Columbia University Medical Center, New York, New York, USA.
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Peper ES, Strijkers GJ, Gazzola K, Potters WV, Motaal AG, Luirink IK, Hutten BA, Wiegman A, van Ooij P, van den Born BJH, Nederveen AJ, Coolen BF. Regional assessment of carotid artery pulse wave velocity using compressed sensing accelerated high temporal resolution 2D CINE phase contrast cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2018; 20:86. [PMID: 30567566 PMCID: PMC6300923 DOI: 10.1186/s12968-018-0499-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 10/23/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) allows for non-invasive assessment of arterial stiffness by means of measuring pulse wave velocity (PWV). PWV can be calculated from the time shift between two time-resolved flow curves acquired at two locations within an arterial segment. These flow curves can be derived from two-dimensional CINE phase contrast CMR (2D CINE PC CMR). While CMR-derived PWV measurements have proven to be accurate for the aorta, this is more challenging for smaller arteries such as the carotids due to the need for both high spatial and temporal resolution. In this work, we present a novel method that combines retrospectively gated 2D CINE PC CMR, high temporal binning of data and compressed sensing (CS) reconstruction to accomplish a temporal resolution of 4 ms. This enables accurate flow measurements and assessment of PWV in regional carotid artery segments. METHODS Retrospectively gated 2D CINE PC CMR data acquired in the carotid artery was binned into cardiac frames of 4 ms length, resulting in an incoherently undersampled ky-t-space with a mean undersampling factor of 5. The images were reconstructed by a non-linear CS reconstruction using total variation over time as a sparsifying transform. PWV values were calculated from flow curves by using foot-to-foot and cross-correlation methods. Our method was validated against ultrasound measurements in a flow phantom setup representing the carotid artery. Additionally, PWV values of two groups of 23 young (30 ± 3 years, 12 [52%] women) and 10 elderly (62 ± 10 years, 5 [50%] women) healthy subjects were compared using the Wilcoxon rank-sum test. RESULTS Our proposed method produced very similar flow curves as those measured using ultrasound at 1 ms temporal resolution. Reliable PWV estimation proved possible for transit times down to 7.5 ms. Furthermore, significant differences in PWV values between healthy young and elderly subjects were found (4.7 ± 1.0 m/s and 7.9 ± 2.4 m/s, respectively; p < 0.001) in accordance with literature. CONCLUSIONS Retrospectively gated 2D CINE PC CMR with CS allows for high spatiotemporal resolution flow measurements and accurate regional carotid artery PWV calculations. We foresee this technique will be valuable in protocols investigating early development of carotid atherosclerosis.
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Affiliation(s)
- Eva S Peper
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Katja Gazzola
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Wouter V Potters
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Ilse K Luirink
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Pediatrics Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Barbara A Hutten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Albert Wiegman
- Department of Pediatrics Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Bert-Jan H van den Born
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Bram F Coolen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
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Deng L, Zhang Y, Zhao Z, Zhang K, Hu X, Gao L, Liang H, Zhang J. Ultrasound simulation model incorporating incident and reflected wave propagations along a common carotid artery. Comput Biol Med 2018; 104:267-277. [PMID: 30551000 DOI: 10.1016/j.compbiomed.2018.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/25/2018] [Accepted: 11/12/2018] [Indexed: 11/28/2022]
Abstract
An ultrasound simulation model incorporating incident and reflected wave propagations is proposed to provide a realistic data source for validation of transit time (TT)-based local pulse wave velocity (PWV) estimation algorithms. First, the incident wave (IW) and reflected wave (RW) at a certain position over a common carotid artery (CCA) are estimated. Then, the propagating pulse waves (PWs) along the CCA are modelled with the synthesizations of the estimated IWs and RWs, whose occurrences are delayed in opposite sequences according to a preset PWV. In ultrasound simulation, a geometric model of a CCA is built, and the dynamic scatterer models are constructed by moving the scatterer positions according to the synthesized PWs. The RF signals are generated using Field II. To characterize the PW propagations of different arterial stiffnesses consistent with clinical ones in the model, 30 healthy subjects from young, middle-aged, and elderly groups are recruited for extractions of IWs and RWs. To quantitatively verify the effectiveness of the simulation model, the normalized root-mean-squared errors (NRMSEs) are used to compare the estimated and preset PWs, time delays (TDs), and PWVs. Results show that for the three age groups, the estimated PWs, TDs, and PWVs conform to the preset ones with the mean NRMSEs of 0.92%, 18.47%, and 8.55%, respectively. Moreover, the model can characterize the effect of the wave reflection on the local PW propagation as its clinical manifestation. Therefore, the proposed model can be effective as a data source for the validation of TT-based local PWV estimation algorithms, particularly the effects of RWs on the estimation performance.
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Affiliation(s)
- Li Deng
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Zhengpeng Zhao
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Kexin Zhang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650031, China
| | - Xiao Hu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Lian Gao
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Hong Liang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Junhua Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
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Pan FS, Xu M, Yu L, Luo J, Li MY, Liang JY, Zheng YL, Xie XY. Relationship between carotid intima-media thickness and carotid artery stiffness assessed by ultrafast ultrasound imaging in patients with type 2 diabetes. Eur J Radiol 2018; 111:34-40. [PMID: 30691662 DOI: 10.1016/j.ejrad.2018.12.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/03/2018] [Accepted: 12/13/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To evaluate the relationship between carotid stiffness and carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM). MATERIALS AND METHODS Carotid properties were evaluated in 317 consecutive subjects (98 volunteers for controls, 105 patients with normal CIMT for T2DM group 1, and 114 patients with thickened CIMT for T2DM group 2). The CIMT and carotid pulse wave velocity at the beginning (PWV-BS) and at the end of systole (PWV-ES) were measured. RESULTS Apart from PWV-BS in T2DM group 1, CIMT and PWV-ES were significant higher in patients groups than those of in controls. In multiple regression analysis, diabetes was independently associated with PWV-ES and not with PWV-BS. Moreover, when adjusting for baseline covariates, only PWV-ES (odds ratio = 4.27, P < 0.001) distinguished carotid in T2DM group 1 from that of controls. Concerning the relationship between log(CIMT) and PWV-ES, when adjusting for baseline covariates, the association were still significant in controls and T2DM group 1, whereas it was no longer present in T2DM group 2 (P = 0.091). Additionally, the slope (β) after adjustment for the PWV-ES to log(CIMT) was significantly steeper in T2DM group 1 than that of in controls (β= 8.35 vs. 3.31, P < 0.01). CONCLUSIONS The PWV-ES seem to be a better biomarker candidate than PWV-BS to assess the carotid stiffness in diabetic patients. Compared with controls, diabetic patients showed more advanced functional changes than morphological changes despite normal CIMT, whereas the relationship trend was not present when thickened CIMT emerged.
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Affiliation(s)
- Fu-Shun Pan
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Ming Xu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Liang Yu
- Department of Vascular and Thyroid Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Jia Luo
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Man-Ying Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Jin-Yu Liang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Yan-Ling Zheng
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Xiao-Yan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
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Zakrzewski AM, Huang AY, Zubajlo R, Anthony BW. Real-Time Blood Pressure Estimation From Force-Measured Ultrasound. IEEE Trans Biomed Eng 2018; 65:2405-2416. [PMID: 30281436 PMCID: PMC10615347 DOI: 10.1109/tbme.2018.2873297] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Our objective is to create a blood pressure measurement device, which may provide a way to easily acquire frequent measurements. Common techniques to measure blood pressure include an arterial catheter, an oscillometric pressure cuff, or an auscultatory pressure cuff. METHODS The approach takes as input ultrasound images of an artery and contact force between the ultrasound array and subject. A subject may perform the self-measurements. Image and force data is analyzed for its quality and used to provide guidance or reject poor measurements. Tissue motions, due to probe contact forces and pulsing blood pressure, are estimated from the ultrasound image. Tissues elasticities and blood pressure are found by optimally fitting the observed tissue motion versus applied forces to a table of predicted motion-pre-generated with a finite element tissue deformation model. The output of the optimization is an estimate of systolic and diastolic blood pressure, arterial stiffness, and surrounding tissue stiffness. RESULTS The real-time implementation of the algorithm was validated on a cohort of 21 single-visit volunteers and on four volunteers self-monitored longitudinally. The systolic and diastolic pressures were compared to oscillometric cuff readings. Regression and Bland-Altman analyses were performed. CONCLUSION Systolic pressure and diastolic pressure can be estimated in real-time and by the subject using this novel non-invasive ultrasound-based method (systolic accuracy/precision: -5.2 mmHg/10.7 mmHg; diastolic accuracy/precision: -3.9/8.0 mmHg). SIGNIFICANCE The method occupies a middle ground between the arterial catheter and cuff-based techniques. It has the potential to give calibration-free results.
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Affiliation(s)
- Aaron M. Zakrzewski
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139
| | - Athena Y. Huang
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139
| | - Rebecca Zubajlo
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139
| | - Brian W. Anthony
- Department of Mechanical Engineering and the Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139 USA
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Khamdaeng T, Terdtoon P. Regional pulse wave velocity and stress in aneurysmal arch-shaped aorta. Biomed Mater Eng 2018; 29:527-549. [PMID: 30282348 DOI: 10.3233/bme-181007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The pulse wave velocity (PWV) has been shown to be associated with the properties of blood vessel and a cardiovascular risk factor such as aneurysm. The global PWV estimation is applied in conventional clinical diagnosis. However, the geometry of blood vessel changes along the wave traveling path and the global PWV estimation may not always detect regional wall changes resulting from cardiovascular diseases. In this study, a fluid structure interaction (FSI) analysis was applied on arch-shaped aortas with and without aneurysm aimed at determining the effects of the number of aneurysm, aneurysm size and the modulus ratio (aneurysm to wall modulus) on the pulse wave propagation and velocity. The characterization for each stage of aneurysmal aorta was simulated by progressively increasing aortic stiffness and aneurysm size. The pulse wave propagations and velocities were estimated from the two-dimensional spatial-temporal plot of the normalized wall displacement based on elastic deformation. The descending forward and arch reflected PWVs of aneurysmal aortic arch models were found up to 9.7% and 122.8%, respectively, deviate from the PWV of non-aneurysmal aortic arch model. The PWV patterns and magnitudes can be used to distinguish the characterization of the normal and aneurysmal aortic walls and shown to be relevant regional markers utilized in clinical diagnosis.
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Affiliation(s)
- Tipapon Khamdaeng
- Department of Agricultural Engineering, Faculty of Engineering and Agro-Industry, Maejo University, Chiang Mai, Thailand
| | - Pradit Terdtoon
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand
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Seo J, Pietrangelo SJ, Sodini CG, Lee HS. Motion Tolerant Unfocused Imaging of Physiological Waveforms for Blood Pressure Waveform Estimation Using Ultrasound. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:766-779. [PMID: 29733280 DOI: 10.1109/tuffc.2018.2812124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This paper details unfocused imaging using single-element ultrasound transducers for motion tolerant arterial blood pressure (ABP) waveform estimation. The ABP waveform is estimated based on pulse wave velocity and arterial pulsation through Doppler and M-mode ultrasound. This paper discusses approaches to mitigate the effect of increased clutter due to unfocused imaging on blood flow and diameter waveform estimation. An intensity reduction model (IRM) estimator is described to track the change of diameter, which outperforms a complex cross-correlation model (C3M) estimator in low contrast environments. An adaptive clutter filtering approach is also presented, which reduces the increased Doppler angle estimation error due to unfocused imaging. Experimental results in a flow phantom demonstrate that flow velocity and diameter waveforms can be reliably measured with wide lateral offsets of the transducer position. The distension waveform estimated from human carotid M-mode imaging using the IRM estimator shows physiological baseline fluctuations and 0.6-mm pulsatile diameter change on average, which is within the expected physiological range. These results show the feasibility of this low cost and portable ABP waveform estimation device.
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41
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Guo Y, Wang Y, Chang EJH, Lee WN. Multidirectional Estimation of Arterial Stiffness Using Vascular Guided Wave Imaging with Geometry Correction. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:884-896. [PMID: 29402485 DOI: 10.1016/j.ultrasmedbio.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/01/2017] [Accepted: 12/12/2017] [Indexed: 06/07/2023]
Abstract
We previously found that vascular guided wave imaging (VGWI) could non-invasively quantify transmural wall stiffness in both the longitudinal (r-z plane, 0°) and circumferential (r-θ plane, 90°) directions of soft hollow cylinders. Arterial stiffness estimation in multiple directions warrants further comprehensive characterization of arterial health, especially in the presence of asymmetric plaques, but is currently lacking. This study therefore investigated the multidirectional estimation of the arterial Young's modulus in a finite-element model, in vitro artery-mimicking phantoms and an excised porcine aorta. A longitudinal pre-stretch of 20% and/or lumen pressure (15 or 70 mm Hg) was additionally introduced to pre-condition the phantoms for emulating the intrinsic mechanical anisotropy of the real artery. The guided wave propagation was approximated by a zero-order antisymmetric Lamb wave model. Shape factor, which was defined as the ratio of inner radius to thickness, was calculated over the entire segment of each planar cross section of the hollow cylindrical structure at a full rotation (0°-360° at 10° increments) about the radial axis. The view-dependent geometry of the cross segment was found to affect the guided wave propagation, causing Young's modulus overestimation in four angular intervals along the propagation pathway, all of which corresponded to wall regions with low shape factors (<1.5). As validated by mechanical tensile testing, the results indicate not only that excluding the propagation pathway with low shape factors could correct the overestimation of Young's modulus, but also that VGWI could portray the anisotropy of hollow cylindrical structures and the porcine aorta based on the derived fractional anisotropy values from multidirectional modulus estimates. This study may serve as an important step toward 3-D assessment of the mechanical properties of the artery.
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Affiliation(s)
- Yuexin Guo
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong
| | - Yahua Wang
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong
| | - Enoch Jing-Han Chang
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong
| | - Wei-Ning Lee
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong; Medical Engineering Programme, The University of Hong Kong, Hong Kong.
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Papadacci C, Mirault T, Dizier B, Tanter M, Messas E, Pernot M. Non-invasive Evaluation of Aortic Stiffness Dependence with Aortic Blood Pressure and Internal Radius by Shear Wave Elastography and Ultrafast Imaging. Ing Rech Biomed 2018. [DOI: 10.1016/j.irbm.2017.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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43
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McGarry M, Nauleau P, Apostolakis I, Konofagou E. In vivo repeatability of the pulse wave inverse problem in human carotid arteries. J Biomech 2017; 64:136-144. [PMID: 29050824 DOI: 10.1016/j.jbiomech.2017.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/08/2017] [Accepted: 09/19/2017] [Indexed: 10/18/2022]
Abstract
Accurate arterial stiffness measurement would improve diagnosis and monitoring for many diseases. Atherosclerotic plaques and aneurysms are expected to involve focal changes in vessel wall properties; therefore, a method to image the stiffness variation would be a valuable clinical tool. The pulse wave inverse problem (PWIP) fits unknown parameters from a computational model of arterial pulse wave propagation to ultrasound-based measurements of vessel wall displacements by minimizing the difference between the model and measured displacements. The PWIP has been validated in phantoms, and this study presents the first in vivo demonstration. The common carotid arteries of five healthy volunteers were imaged five times in a single session with repositioning of the probe and subject between each scan. The 1D finite difference computational model used in the PWIP spanned from the start of the transducer to the carotid bifurcation, where a resistance outlet boundary condition was applied to approximately model the downstream reflection of the pulse wave. Unknown parameters that were estimated by the PWIP included a 10-segment linear piecewise compliance distribution and 16 discrete cosine transformation coefficients for each of the inlet boundary conditions. Input data was selected to include pulse waves resulting from the primary pulse and dicrotic notch. The recovered compliance maps indicate that the compliance increases close to the bifurcation, and the variability of the average pulse wave velocity estimated through the PWIP is on the order of 11%, which is similar to that of the conventional processing technique which tracks the wavefront arrival time (13%).
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Affiliation(s)
- Matthew McGarry
- Department of Biomedical Engineering, Columbia University, New York, NY, United States; Thayer School of Engineering, Dartmouth College, Hanover, NH, United States
| | - Pierre Nauleau
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Iason Apostolakis
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Elisa Konofagou
- Department of Biomedical Engineering, Columbia University, New York, NY, United States; Department of Radiology, Columbia University, New York, NY, United States.
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44
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Apostolakis IZ, Nauleau P, Papadacci C, McGarry MD, Konofagou EE. Feasibility and Validation of 4-D Pulse Wave Imaging in Phantoms and In Vivo. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2017; 64:1305-1317. [PMID: 28792891 PMCID: PMC5823504 DOI: 10.1109/tuffc.2017.2735381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Pulse wave imaging (PWI) is a noninvasive technique for tracking the propagation of the pulse wave along the arterial wall. The 3-D ultrasound imaging would aid in objectively estimating the pulse wave velocity (PWV) vector. This paper aims to introduce a novel PWV estimation method along the propagation direction, validate it in phantoms, and test its feasibility in vivo. A silicone vessel phantom consisting of a stiff and a soft segment along the longitudinal axis and a silicone vessel with a plaque were constructed. A 2-D array with a center frequency of 2.5 MHz was used. Propagation was successfully visualized in 3-D in each phantom and in vivo in six healthy subjects. In three of the healthy subjects, results were compared against conventional PWI using a linear array. PWVs were estimated in the stiff (3.42 ± 0.23 m [Formula: see text]) and soft (2.41 ± 0.07 m [Formula: see text]) phantom segments. Good agreement was found with the corresponding static testing values (stiff: 3.41 m [Formula: see text] and soft: 2.48 m [Formula: see text]). PWI-derived vessel compliance values were validated with dynamic testing. Comprehensive views of pulse propagation in the plaque phantom were generated and compared against conventional PWI acquisitions. Good agreement was found in vivo between the results of 4-D PWI (4.80 ± 1.32 m [Formula: see text]) and conventional PWI (4.28±1.20 m [Formula: see text]) ( n=3 ). PWVs derived for all of the healthy subjects ( n = 6 ) were within the physiological range. Thus, the 4-D PWI was successfully validated in phantoms and used to image the pulse wave propagation in normal human subjects in vivo.
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45
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Carotid artery plaque and arterial stiffness. J Hypertens 2017; 35:1569-1572. [DOI: 10.1097/hjh.0000000000001394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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46
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He Q, Li GY, Lee FF, Zhang Q, Cao Y, Luo J. Novel Method for Vessel Cross-Sectional Shear Wave Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:1520-1532. [PMID: 28408062 DOI: 10.1016/j.ultrasmedbio.2017.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 02/22/2017] [Accepted: 03/06/2017] [Indexed: 06/07/2023]
Abstract
Many studies have investigated the applications of shear wave imaging (SWI) to vascular elastography, mainly on the longitudinal section of vessels. It is important to investigate SWI in the arterial cross section when evaluating anisotropy of the vessel wall or complete plaque composition. Here, we proposed a novel method based on the coordinate transformation and directional filter in the polar coordinate system to achieve vessel cross-sectional shear wave imaging. In particular, ultrasound radiofrequency data were transformed from the Cartesian to the polar coordinate system; the radial displacements were then estimated directly. Directional filtering was performed along the circumferential direction to filter out the reflected waves. The feasibility of the proposed vessel cross-sectional shear wave imaging method was investigated through phantom experiments and ex vivo and in vivo studies. Our results indicated that the dispersion relation of the shear wave (i.e., the guided circumferential wave) within the vessel can be measured via the present method, and the elastic modulus of the vessel can be determined.
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Affiliation(s)
- Qiong He
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China
| | - Guo-Yang Li
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, China
| | - Fu-Feng Lee
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China
| | - Qihao Zhang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Yanping Cao
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, China
| | - Jianwen Luo
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China.
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47
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Sanz-Miralles EC, Li R, Momen-Heravi F, Mendieta C, Konofagou EE, Papapanou PN. Assessment of arterial stiffness in periodontitis using a novel pulse wave imaging methodology. J Clin Periodontol 2017; 44:502-510. [PMID: 28278360 DOI: 10.1111/jcpe.12717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 12/23/2022]
Abstract
AIM We investigated the cross-sectional relationship between periodontal status and arterial stiffness, assessed through a novel Pulse Wave Imaging methodology. METHODS Eighty volunteers were enrolled (39% male, age range 24-78 years) and 33 pairs were formed of periodontitis patients/periodontally healthy controls, matched by age and gender. A full-mouth periodontal examination was performed and the degree of stiffness of the right and left carotid arteries was assessed by measuring pulse wave velocity (PWV) and the uniformity in pulse wave propagation (R2 ). Wilcoxon signed-rank tests for paired observations were used to compare periodontitis patients and healthy controls. Univariate and multivariate analyses were performed to analyze the association between PWV and R2 and potential explanatory variables. RESULTS Patients with periodontitis had a statistically significantly lower uniformity in wave propagation (R2 ) than controls (p = .01), but PWV did not differ between the two groups. Univariate analysis showed a significant negative association between R2 and periodontitis, body mass index and smoking; periodontitis remained statistically associated with R2 in the multivariate analyses. CONCLUSIONS Patients with periodontitis and no established cardiovascular disease presented with lower degree of uniformity in the transmission of the pulse wave through the carotid arteries, suggesting an association between periodontitis and arterial stiffness/functional alterations.
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Affiliation(s)
- Elena C Sanz-Miralles
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
| | - Ronny Li
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Fatemeh Momen-Heravi
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
| | - Carlos Mendieta
- Periodontics Unit, Faculty of Odontology, University of Barcelona, Barcelona, Spain
| | - Elisa E Konofagou
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
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48
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Garner T, Ouyang A, Berrones AJ, Campbell MS, Du B, Fleenor BS. Sweet potato (Ipomoea batatas) attenuates diet-induced aortic stiffening independent of changes in body composition. Appl Physiol Nutr Metab 2017; 42:802-809. [PMID: 28288284 DOI: 10.1139/apnm-2016-0571] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We hypothesized a sweet potato intervention would prevent high-fat (HF) diet-induced aortic stiffness, which would be associated with decreased arterial oxidative stress and increased mitochondrial uncoupling. Young (8-week old) C57BL/6J mice were randomly divided into 4 groups: low fat (LF; 10% fat), HF (60% fat), low-fat sweet potato (LFSP; 10% fat containing 260.3 μg/kcal sweet potato), or high-fat sweet potato diet (HFSP; 60% fat containing 260.3 μg/kcal sweet potato) for 16 weeks. Compared with LF and LFSP, HF- and HFSP-fed mice had increased body mass and percent fat mass with lower percent lean mass (all, P < 0.05). Sweet potato intervention did not influence body composition (all, P > 0.05). Arterial stiffness, assessed by aortic pulse wave velocity and ex vivo mechanical testing of the elastin region elastic modulus (EEM) was greater in HF compared with LF and HFSP animals (all, P < 0.05). Advanced glycation end products and nitrotyrosine abundance were greater in aortic segments from HF mice compared with LF and HFSP animals (all, P < 0.05). Aortic elastin and uncoupling protein 2 expressions, however, were reduced in HF compared with LF and HFSP mice (all, P < 0.05). Aortic segments cultured with 2,4-dinitrophenol (DNP), a mitochondrial uncoupler, for 72 h reduced the EEM of HF arteries compared with nontreated HF segments (P < 0.05). DNP had no effect on the EEM of aortic segments from HFSP mice. In conclusion, sweet potato attenuates diet-induced aortic stiffness independent of body mass and composition, which is associated with a normalization of arterial oxidative stress possibly due to mitochondrial uncoupling.
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Affiliation(s)
- Tyler Garner
- a Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA
| | - An Ouyang
- a Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA
| | - Adam J Berrones
- a Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA
| | - Marilyn S Campbell
- a Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA
| | - Bing Du
- b Department of Cardiology, The First Hospital of Jilin University, Changchun 130000, China
| | - Bradley S Fleenor
- a Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA
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Li RX, Ip A, Sanz-Miralles E, Konofagou EE. Noninvasive Evaluation of Varying Pulse Pressures in vivo Using Brachial Sphymomanometry, Applanation Tonometry, and Pulse Wave Ultrasound Manometry. Artery Res 2017; 18:22-28. [PMID: 28989555 DOI: 10.1016/j.artres.2017.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The routine assessment and monitoring of hypertension may benefit from the evaluation of arterial pulse pressure (PP) at more central locations (e.g. the aorta) rather solely at the brachial artery. Pulse Wave Ultrasound Manometry (PWUM) was previously developed by our group to provide direct, noninvasive aortic PP measurements using ultrasound elasticity imaging. Using PWUM, radial applanation tonometry, and brachial sphygmomanometry, this study investigated the feasibility of noninvasively obtaining direct PP measurements at multiple arterial locations in normotensive, pre-hypertensive, and hypertensive human subjects. Two-way ANOVA indicated a significantly higher aortic PP in the hypertensive subjects, while radial and brachial PP were not significantly different among the subject groups. No strong correlation (r2 < 0.45) was observed between aortic and radial/brachial PP in normal and pre-hypertensive subjects, suggesting that increases in PP throughout the arterial tree may not be uniform in relatively compliant arteries. However, there was a relatively strong positive correlation between aortic PP and both radial and brachial PP in hypertensive subjects (r2 = 0.68 and 0.87, respectively). PWUM provides a low-cost, non-invasive, and direct means of measuring the pulse pressure in large central arteries such as the aorta. When used in conjunction with peripheral measurement devices, PWUM allows for the routine screening of hypertension and monitoring of BP-lowering drugs based on the PP from multiple arterial sites.
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Affiliation(s)
- Ronny X Li
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Ada Ip
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Elena Sanz-Miralles
- Department of Dental Medicine, Columbia University Medical Center, New York, NY, USA
| | - Elisa E Konofagou
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA.,Department of Radiology, Columbia University Medical Center, New York, NY, USA
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50
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Li GY, He Q, Jia L, He P, Luo J, Cao Y. An Inverse Method to Determine Arterial Stiffness with Guided Axial Waves. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:505-516. [PMID: 27908486 DOI: 10.1016/j.ultrasmedbio.2016.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 10/09/2016] [Accepted: 10/19/2016] [Indexed: 05/26/2023]
Abstract
Many cardiovascular diseases can alter arterial stiffness; therefore, measurement of arterial wall stiffness can provide valuable information for both diagnosis of such diseases in the clinic and evaluation of the effectiveness of relevant drugs. However, quantitative assessment of the in vivo elastic properties of arterial walls in a non-invasive manner remains a great challenge. In this study, we found that the elastic modulus of the arterial wall can be extracted from the dispersion curve of the guided axial wave (GAW) measured using the ultrasound elastography method. It is shown that the GAW in the arterial wall can be well described with the Lamb wave (LW) model when the frequency exceeds a critical value fc, whose explicit form is determined here based on dimensional analysis method and systematic finite-element simulations. Further, an inverse procedure is proposed to determine both fc and the elastic modulus of the arterial wall. Phantom experiments have been performed to validate the inverse method and illustrate its potential use in the clinic.
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Affiliation(s)
- Guo-Yang Li
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, China
| | - Qiong He
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Lin Jia
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, China
| | - Ping He
- Department of Ultrasonography, Peking University Third Hospital, Beijing, China
| | - Jianwen Luo
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Yanping Cao
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, China.
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