Correlation of carotid bruits and carotid atherosclerosis detected by B-mode real-time ultrasonography.

Howard, Virginia J.; Howard, George; Harpold, Gary J.; Nunn, Cathy; Myers, L G; McKinney, William Mark; Murros, Kari; Toole, James F.

doi:10.1161/01.str.20.10.1331

Cited by 12 publications

(1 citation statement)

References 23 publications

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“…From a hemodynamics standpoint, the presence of stenosis perturbs blood flow, and in turn it may lead to flow instability . This phenomenon forms the underlying basis for physical examinations of carotid atherosclerosis via the detection of carotid bruit using a stethoscope . Unstable blood flow (i.e., nonlaminar flow, including turbulence) has also been associated with atherogenesis and plaque progression, as well as an increased risk for thrombosis and embolization .…”

Section: Introductionmentioning

confidence: 99%

High frame rate doppler ultrasound bandwidth imaging for flow instability mapping

Yiu

Chee

Tang³

et al. 2019

Medical Physics

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Purpose Flow instability has been shown to contribute to the risk of future cardiovascular and cerebrovascular events. Nonetheless, it is challenging to noninvasively detect and identify flow instability in blood vessels. Here, we present a new framework called Doppler ultrasound bandwidth imaging ( DUBI ) that uses high‐frame‐rate ultrasound and Doppler bandwidth analysis principles to assess flow instability within an image view. Methods Doppler ultrasound bandwidth imaging seeks to estimate the instantaneous Doppler bandwidth based on autoregressive modeling at every pixel position of data frames acquired from high‐frame‐rate plane wave pulsing. This new framework is founded upon the principle that flow instability naturally gives rise to a wide range of flow velocities over a sample volume, and such velocity range in turn yields a larger Doppler bandwidth estimate. The ability for DUBI to map unstable flow was first tested over a range of fluid flow conditions (ranging from laminar to turbulent) with a nozzle‐flow phantom. As a further demonstration, DUBI was applied to assess flow instability in healthy and stenosed carotid bifurcation phantoms. Results Nozzle‐flow phantom results showed that DUBI can effectively detect and visualize the difference in Doppler bandwidth magnitude (increased from 2.1 to 5.2 kH z) at stable and unstable flow regions in an image view. Receiver operating characteristic analysis also showed that DUBI can achieve optimal sensitivity and specificity of 0.72 and 0.83, respectively. In the carotid phantom experiments, differences were observed in the spatiotemporal dynamics of Doppler bandwidth over a cardiac cycle. Specifically, as the degree of stenosis increased (from 50% to 75%), DUBI showed an increase in Doppler bandwidth magnitude from 1.4 kH z in the healthy bifurcation to 7.7 kH z at the jet tail located downstream from a 75% stenosis site, thereby indicating flow perturbation in the stenosed bifurcations. Conclusion DUBI can detect unstable flow. This new technique can provide useful hemodynamic information that may aid clinical diagnosis of atherosclerosis.

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Section: Introductionmentioning

confidence: 99%