超声定位显微镜评估大动脉炎活动度。

Assessment of Takayasu's arteritis activity by ultrasound localization microscopy.

机构信息

Vascular Medicine Department, Georges Pompidou European Hospital, APHP, Paris, France; Université Paris Cité, INSERM U970 PARCC, F-75015 Paris, France.

Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS UMR 8631, PSL Research University, Paris, France.

出版信息

EBioMedicine. 2023 Apr;90:104502. doi: 10.1016/j.ebiom.2023.104502. Epub 2023 Mar 7.

DOI:10.1016/j.ebiom.2023.104502

PMID:36893585

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10017361/

Abstract

BACKGROUND

Ultrasound localization microscopy (ULM) based on ultrafast ultrasound imaging of circulating microbubbles (MB) can image microvascular blood flows in vivo up to the micron scale. Takayasu arteritis (TA) has an increased vascularisation of the thickened arterial wall when active. We aimed to perform vasa vasorum ULM of the carotid wall and demonstrate that ULM can provide imaging markers to assess the TA activity.

METHODS

Patients with TA were consecutively included with assessment of activity by the National Institute of Health criteria: 5 had active TA (median age 35.8 [24.5-46.0] years) and 11 had quiescent TA (37.2 [31.7-47.3] years). ULM was performed using a 6.4 MHz probe and a dedicated imaging sequence (plane waves with 8 angles, frame rate 500 Hz), coupled with the intravenous injection of MB. Individual MB were localised at a subwavelength scale then tracked, allowing the reconstruction of the vasa vasorum flow anatomy and velocity.

FINDINGS

ULM allowed to show microvessels and to measure their flow velocity within the arterial wall. The number of MB detected per second in the wall was 121 [80-146] in active cases vs. 10 [6-15] in quiescent cases (p = 0.0005), with a mean velocity of 40.5 [39.0-42.9] mm.s in active cases.

INTERPRETATION

ULM allows visualisation of microvessels within the thickened carotid wall in TA, with significantly greater MB density in active cases. ULM provides a precise visualisation in vivo of the vasa vasorum and gives access to the arterial wall vascularisation quantification.

FUNDING

French Society of Cardiology. ART (Technological Research Accelerator) biomedical ultrasound program of INSERM, France.

摘要

背景

基于循环微泡（MB）的超快超声成像的超声定位显微镜（ULM）可以在体内对微米级的微血管血流进行成像。当活动时，大动脉炎（TA）的增厚动脉壁会增加血管生成。我们旨在对颈动脉壁进行血管生成 ULM，并证明 ULM 可以提供成像标志物来评估 TA 的活动。

方法

连续纳入 TA 患者，并通过 NIH 标准评估其活动：5 例 TA 处于活动期（中位年龄 35.8 [24.5-46.0] 岁），11 例 TA 处于静止期（37.2 [31.7-47.3] 岁）。使用 6.4 MHz 探头和专用成像序列（平面波，8 个角度，帧率 500 Hz）进行 ULM，同时静脉注射 MB。以亚波长尺度定位单个 MB，然后进行跟踪，从而重建血管生成的血管解剖结构和流速。