Characterization of blood clot viscoelasticity by dynamic ultrasound elastography and modeling of the rheological behavior.

Dynamic elastography (DE) is a new tool to study mechanical behavior of soft tissues via their motion response to propagating shear waves. This technique characterized viscoelasticity of 9 porcine whole blood samples (3 animals) during coagulation for a shearing frequency of 70Hz, and after complete clot formation between 50 and 160Hz. Clot storage (G') and loss (G″) moduli were calculated from shear wave velocity and attenuation. Temporal evolutions of G' and G″ during coagulation were typified with 4 parameters: maximum change in elasticity (G' slope(max)), elasticity after 120min of coagulation (G'(max)), time occurrence of G″ maximum (t(e)) and G″ at the plateau (G″(plateau)). G' and G″ frequency dependence of completely formed blood clots was fitted with 5 standard rheological models: Maxwell, Kelvin-Voigt, Jeffrey, Zener and third-order generalized Maxwell. DE had sufficient sensitivity to follow the coagulation kinetics described by a progressive increase in G', while G″ transitory increased followed by a rapid stabilization. Inter- and intra-animal dispersions (InterAD and IntraAD) of G'(max) (InterAD=15.9%, IntraAD=9.1%) showed better reproducibility than G' slope(max) (InterAD=40.4%, IntraAD=21.9%), t(e) (InterAD=27.4%, IntraAD=18.7%) and G″(plateau) (InterAD=58.6%, IntraAD=40.2%). G' evolution within the considered range of frequency exhibited an increase, followed by stabilization to a plateau, whereas G″ presented little variations with convergence at a quasi-constant value at highest frequencies. Residues χ(⁎), describing the goodness of fit between models and experimental data, showed statistically (p<0.05) that the Kelvin-Voigt model was less in agreement with experimental data than other models. The Zener model is recommended to predict G' and G″ dispersion of coagulated blood over the explored frequency range.