Department of Radiology, Mayo Clinic, Minnesota, 200 First St SW, Rochester, MN 55905, United States of America.
Author to whom any correspondence should be addressed.
Phys Med Biol. 2021 Jan 26;66(3):035013. doi: 10.1088/1361-6560/abcb1e.
Thromboembolism in a cerebral blood vessel is associated with high morbidity and mortality. Mechanical thrombectomy (MT) is one of the emergenc proceduresperformed to remove emboli. However, the interventional approaches such as aspiration catheters or stent retriever are empirically selected. An inappropriate selection of surgical devices can influence the success rate during embolectomy, which can lead to an increase in brain damage. There has been growing interest in the study of clot composition and using a priori knowledge of clot composition to provide guidance for an appropriate treatment strategy for interventional physicians. Developing imaging tools which can allow interventionalists to understand clot composition could affect management and device strategy. In this study, we investigated how clots of different compositions can be characterized by using acoustic radiation force optical coherence elastography (ARF-OCE) and compared with ultrasound shear wave elastography (SWE). Five different clots compositions using human blood were fabricated into cylindrical forms from fibrin-rich (21% red blood cells, RBCs) to RBC-rich (95% RBCs). Using the ARF-OCE and SWE, we characterized the wave velocities measured in the time-domain. In addition, the semi-analytical finite element model was used to explore the relationship between the phase velocities with various frequency ranges and diameters of the clots. The study demonstrated that the wave group velocities generally decrease as RBC content increases in ARF-OCE and SWE. The correlation of the group velocities from the OCE and SWE methods represented a good agreement as RBC composition is larger than 39%. Using the phase velocity dispersion analysis applied to ARF-OCE data, we estimated the shear wave velocities decoupling the effects of the geometry and material properties of the clots. The study demonstrated that the composition of the clots can be characterized by elastographic methods using ARF-OCE and SWE, and OCE demonstrated better ability to discriminate between clots of different RBC compositions, compared to the ultrasound-based approach, especially in clots with low RBC compositions.
脑血管血栓栓塞与高发病率和高死亡率相关。机械血栓切除术 (MT) 是用于清除栓子的紧急程序之一。然而,抽吸导管或支架取栓器等介入方法是经验性选择的。手术器械选择不当会影响取栓术的成功率,从而导致脑损伤增加。人们越来越关注血栓成分的研究,并利用血栓成分的先验知识为介入医师提供适当的治疗策略指导。开发能够使介入医师了解血栓成分的成像工具可能会影响管理和器械策略。在这项研究中,我们通过声辐射力光学相干弹性成像 (ARF-OCE) 研究了不同成分的血栓如何进行特征描述,并将其与超声剪切波弹性成像 (SWE) 进行了比较。使用富含纤维蛋白的(21%红细胞,RBC)到富含 RBC 的(95%RBC)五种不同的人血制备成圆柱形血栓。使用 ARF-OCE 和 SWE,我们在时域中测量了波速。此外,半解析有限元模型用于探索不同频率范围和血栓直径的相位速度与频率之间的关系。研究表明,在 ARF-OCE 和 SWE 中,随着 RBC 含量的增加,波群速度通常会降低。当 RBC 组成大于 39%时,OCE 和 SWE 方法的群速度相关性表现出很好的一致性。通过应用于 ARF-OCE 数据的相速度频散分析,我们估计了剪切波速度,该速度可分离血栓的几何形状和材料特性的影响。研究表明,ARF-OCE 和 SWE 等弹性成像方法可以对血栓的成分进行特征描述,与基于超声的方法相比,OCE 显示出更好的区分不同 RBC 成分血栓的能力,尤其是在 RBC 成分较低的血栓中。
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