TY - JOUR
T1 - US velocimetry in participants with aortoiliac occlusive disease
AU - Engelhard, Stefan
AU - van Helvert, Majorie
AU - Voorneveld, Jason
AU - Bosch, Johan G.
AU - Lajoinie, Guillaume P.R.
AU - Versluis, Michel
AU - Jebbink, Erik Groot
AU - Reijnen, Michel M.P.J.
N1 - Funding Information:
Supported in part by a private charitable organization, the Lijf en Leven Foundation, based in Krimpen aan den IJssel, the Netherlands.
Publisher Copyright:
© 2021 Radiological Society of North America Inc.. All rights reserved.
PY - 2021/11
Y1 - 2021/11
N2 - Background: The accurate quantification of blood flow in aortoiliac arteries is challenging but clinically relevant because local flow patterns can influence atherosclerotic disease. Purpose: To investigate the feasibility and clinical application of two-dimensional blood flow quantification using high-frame-rate contrast-enhanced US (HFR-CEUS) and particle image velocimetry (PIV), or US velocimetry, in participants with aortoiliac stenosis. Materials and Methods: In this prospective study, participants with a recently diagnosed aortoiliac stenosis underwent HFR-CEUS measurements of the pre- and poststenotic vessel segments (August 2018 to July 2019). Two-dimensional quantification of blood flow was achieved by performing PIV analysis, which was based on pairwise cross-correlation of the HFR-CEUS images. Visual inspection of the entire data set was performed by five observers to evaluate the ability of the technique to enable adequate visualization of blood flow. The contrast-to-background ratio and average vector correlation were calculated. In two participants who showed flow disturbances, the flow complexity and vorticity were calculated. Results: Thirty-five participants (median age, 67 years; age range, 56–84 years; 22 men) were included. Visual scoring showed that flow quantification was achieved in 41 of 42 locations. In 25 locations, one or multiple issues occurred that limited optimal flow quantification, including loss of correlation during systole (n = 12), shadow regions (n = 8), a short vessel segment in the image plane (n = 7), and loss of contrast during diastole (n = 5). In the remaining 16 locations, optimal quantification was achieved. The contrast-to-background ratio was higher during systole than during diastole (11.0 6 2.9 vs 6.9 6 3.4, respectively; P , .001), whereas the vector correlation was lower (0.58 6 0.21 vs 0.47 6 0.13; P , .001). The flow complexity and vorticity were high in regions with disturbed flow. Conclusion: Blood flow quantification with US velocimetry is feasible in patients with an aortoiliac stenosis, but several challenges must be overcome before implementation into clinical practice.
AB - Background: The accurate quantification of blood flow in aortoiliac arteries is challenging but clinically relevant because local flow patterns can influence atherosclerotic disease. Purpose: To investigate the feasibility and clinical application of two-dimensional blood flow quantification using high-frame-rate contrast-enhanced US (HFR-CEUS) and particle image velocimetry (PIV), or US velocimetry, in participants with aortoiliac stenosis. Materials and Methods: In this prospective study, participants with a recently diagnosed aortoiliac stenosis underwent HFR-CEUS measurements of the pre- and poststenotic vessel segments (August 2018 to July 2019). Two-dimensional quantification of blood flow was achieved by performing PIV analysis, which was based on pairwise cross-correlation of the HFR-CEUS images. Visual inspection of the entire data set was performed by five observers to evaluate the ability of the technique to enable adequate visualization of blood flow. The contrast-to-background ratio and average vector correlation were calculated. In two participants who showed flow disturbances, the flow complexity and vorticity were calculated. Results: Thirty-five participants (median age, 67 years; age range, 56–84 years; 22 men) were included. Visual scoring showed that flow quantification was achieved in 41 of 42 locations. In 25 locations, one or multiple issues occurred that limited optimal flow quantification, including loss of correlation during systole (n = 12), shadow regions (n = 8), a short vessel segment in the image plane (n = 7), and loss of contrast during diastole (n = 5). In the remaining 16 locations, optimal quantification was achieved. The contrast-to-background ratio was higher during systole than during diastole (11.0 6 2.9 vs 6.9 6 3.4, respectively; P , .001), whereas the vector correlation was lower (0.58 6 0.21 vs 0.47 6 0.13; P , .001). The flow complexity and vorticity were high in regions with disturbed flow. Conclusion: Blood flow quantification with US velocimetry is feasible in patients with an aortoiliac stenosis, but several challenges must be overcome before implementation into clinical practice.
UR - http://www.scopus.com/inward/record.url?scp=85118153550&partnerID=8YFLogxK
U2 - 10.1148/radiol.2021210454
DO - 10.1148/radiol.2021210454
M3 - Article
C2 - 34427462
AN - SCOPUS:85118153550
VL - 301
SP - 332
EP - 338
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 2
ER -