Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada.
Collège André-Grasset, Montréal, Québec, Canada.
J Ultrasound Med. 2022 Mar;41(3):685-697. doi: 10.1002/jum.15750. Epub 2021 May 14.
To study the impact of varying the external compression exerted by the ultrasound probe when performing a carotid strain elastography exam.
Nine healthy volunteers (mean age 43 years ±13 years; 6 men) underwent a vascular ultrasound elastography exam using a custom made sound feedback handle embedding the probe, and allowing the sonographer to adjust the applied compression. A clinical standard practice (SP) force was first recorded, and then predetermined compression (PDC) forces were applied, ranging from 0 to 5 N for the left common carotid artery (CCA) or 2-12 N for the left internal carotid artery (ICA). Six carotid elastography features, namely maximum and cumulated axial strains, maximum and cumulated shear strains, cumulated axial translation, and cumulated lateral translation were assessed with noninvasive vascular elastography (NIVE) on near and far walls of carotids. The carotid intima media thickness (IMT) and diameter were also measured.
All elastography features on the near wall of both CCA and ICA decreased statistically significantly as the PDC force increased; this association was also observed for half of the features on the far wall. Three NIVE features at the lowest PDC force (out of 72 that were tested) were statistically significantly different than values at the SP force. Overall, NIVE showed some variance to probe compression with linear regression slopes revealing changes of 10.1%-45.6% in magnitude over the whole compression range on both walls. The maximum IMT for the ICA near wall, and carotid lumen diameters of both CCA and ICA were statistically significantly associated with PDC forces; these features underwent a decrease of 10.2%, 36.2%, and 17.6%, respectively, over the whole range of PDC force increase. Other IMT measurements were not statistically significantly associated with applied PDC forces.
These results suggest the need of technical guidelines for carotid strain elastography. Using the lowest probe compression while allowing a good B-mode image quality is recommended to improve the robustness of NIVE measurements.
研究在进行颈动脉应变弹性成像检查时改变超声探头外部压缩力对检查结果的影响。
9 名健康志愿者（平均年龄 43 岁±13 岁；6 名男性）接受了使用定制声音反馈手柄嵌入探头的血管超声弹性成像检查，该手柄允许超声医师调整施加的压力。首先记录临床标准实践（SP）力，然后施加预定的压缩（PDC）力，范围为左颈总动脉（CCA）的 0 至 5N 或左颈内动脉（ICA）的 2-12N。使用近壁和远壁的非侵入性血管弹性成像（NIVE）评估了 6 个颈动脉弹性成像特征，即最大和累积轴向应变、最大和累积剪切应变、累积轴向平移和累积侧向平移。还测量了颈动脉内膜中层厚度（IMT）和直径。
随着 PDC 力的增加，CCA 和 ICA 近壁的所有弹性成像特征均呈统计学显著下降；远壁的一半特征也观察到了这种关联。在最低的 PDC 力下（在测试的 72 个特征中）有 3 个 NIVE 特征与 SP 力下的值有统计学显著差异。总的来说，NIVE 显示出与探头压缩的一些差异，线性回归斜率表明在整个压缩范围内，近壁和远壁的幅度变化为 10.1%-45.6%。ICA 近壁的最大 IMT 和 CCA 和 ICA 的颈动脉管腔直径与 PDC 力呈统计学显著相关；在整个 PDC 力增加范围内，这些特征分别下降了 10.2%、36.2%和 17.6%。其他 IMT 测量值与施加的 PDC 力无统计学显著相关性。
这些结果表明需要制定颈动脉应变弹性成像技术指南。建议在允许获得良好 B 型超声图像质量的情况下使用最低的探头压缩力，以提高 NIVE 测量的稳健性。
