High-frame-rate contrast-enhanced ultrasound particle image velocimetry in patients with a stented superficial femoral artery: a feasibility study

Majorie van Helvert*, Stefan Engelhard, Jason Voorneveld, Marije van der Vee, Johan G Bosch, Michel Versluis, Erik Groot Jebbink, Michel M P J Reijnen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: Local blood flow affects vascular disease and outcomes of endovascular treatment, but quantifying it is challenging, especially inside stents. We assessed the feasibility of blood flow quantification in native and stented femoral arteries, using high-frame-rate (HFR) contrast-enhanced ultrasound (CEUS) particle image velocimetry (PIV), also known as echoPIV.

METHODS: Twenty-one patients with peripheral arterial disease, recently treated with a stent in the femoral artery, were included. HFR CEUS measurements were performed in the native femoral artery and at the inflow and outflow of the stent. Two-dimensional blood flow was quantified through PIV analysis. EchoPIV recordings were visually assessed by five observers and categorised as optimal, partial, or unfeasible. To evaluate image quality and tracking performance, contrast-to-tissue ratio (CTR) and vector correlation were calculated, respectively.

RESULTS: Fifty-eight locations were measured and blood flow quantification was established in 49 of them (84%). Results were optimal for 17/58 recordings (29%) and partial for 32 recordings (55%) due to loss of correlation (5/32; 16%), short vessel segment (8/32; 25%), loss of contrast (14/32; 44%), and/or shadows (18/32; 56%). In the remaining 9/58 measurements (16%) no meaningful flow information was visualised. Overall, CTR and vector correlation were lower during diastole. CTR and vector correlation were not different between stented and native vessel segments, except for a higher native CTR at the inflow during systole (p = 0.037).

CONCLUSIONS: Blood flow quantification is feasible in untreated and stented femoral arteries using echoPIV. Limitations remain, however, none of them related to the presence of the stent.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT04934501 (retrospectively registered).

Original languageEnglish
Article number32
JournalEuropean radiology experimental
Volume6
Issue number1
DOIs
Publication statusPublished - 6 Jul 2022

Bibliographical note

Funding Information:
This work has been funded by an unrestricted grant from Rijnstate Vriendenfonds (#VF10-a7) and is part of the VORTECS project which is financed by the Dutch Research Council (#17219).

Publisher Copyright:
© 2022, The Author(s) under exclusive licence to European Society of Radiology.

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