Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Department of Radiology, Mayo Clinic College of Medicine and Science, 200 1st Street SW, Rochester, MN, 55905, USA.
Sci Rep. 2023 Jul 13;13(1):11321. doi: 10.1038/s41598-023-38576-x.
While being a relatively prevalent condition particularly among aging patients, peripheral arterial disease (PAD) of lower extremities commonly goes undetected or misdiagnosed due to its symptoms being nonspecific. Additionally, progression of PAD in the absence of timely intervention can lead to dire consequences. Therefore, development of non-invasive and affordable diagnostic approaches can be highly beneficial in detection and treatment planning for PAD patients. In this study, we present a contrast-free ultrasound-based quantitative blood flow imaging technique for PAD diagnosis. The method involves monitoring the variations of blood flow in the calf muscle in response to thigh-pressure-cuff-induced occlusion. Four quantitative metrics are introduced for analysis of these variations. These metrics include post-occlusion to baseline flow intensity variation (PBFIV), total response region (TRR), Lag0 response region (L0RR), and Lag4 (and more) response region (L4 + RR). We examine the feasibility of this method through an in vivo study consisting of 14 PAD patients with abnormal ankle-brachial index (ABI) and 8 healthy volunteers. Ultrasound data acquired from 13 legs in the patient group and 13 legs in the healthy group are analyzed. Out of the four utilized metrics, three exhibited significantly different distributions between the two groups (p-value < 0.05). More specifically, p-values of 0.0015 for PBFIV, 0.0183 for TRR, and 0.0048 for L0RR were obtained. The results of this feasibility study indicate the diagnostic potential of the proposed method for the detection of PAD.
虽然下肢外周动脉疾病（PAD）在老年患者中较为常见，但由于其症状不特异，常被漏诊或误诊。此外，PAD 如不及时干预，病情会恶化。因此，开发无创、经济实惠的诊断方法，对 PAD 患者的检测和治疗计划非常有益。在这项研究中，我们提出了一种基于超声的无对比定量血流成像技术，用于 PAD 的诊断。该方法通过监测小腿肌肉血流对大腿压力袖带诱发的阻塞的反应来实现。我们引入了四个定量指标来分析这些变化。这些指标包括闭塞后到基线血流强度变化（PBFIV）、总反应区域（TRR）、Lag0 反应区域（L0RR）和 Lag4（及以上）反应区域（L4+RR）。我们通过一项包含 14 名踝肱指数（ABI）异常的 PAD 患者和 8 名健康志愿者的体内研究来检验该方法的可行性。对患者组 13 条腿和健康组 13 条腿的超声数据进行了分析。在这四个指标中，有三个在两组之间的分布存在显著差异（p 值<0.05）。更具体地说，PBFIV 的 p 值为 0.0015，TRR 的 p 值为 0.0183，L0RR 的 p 值为 0.0048。这项可行性研究的结果表明，该方法在检测 PAD 方面具有诊断潜力。
