Estimating Thrombus Elasticity by Shear Wave Elastography to Evaluate Ultrasound Thrombolysis for Thrombus With Different Stiffness

Rayes, Adnan; Zhang, Junhang; Lu, Guoxing; Qian, Xuejun; Schroff, Stuart; Ryu, Robert K.; Jiang, Xiaoning; Zhou, Qifa

doi:10.1109/tbme.2022.3186586

Cited by 6 publications

(7 citation statements)

References 50 publications

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“…In the case of the present study, significant effects of the treatment on elasticity were found between the two treatment conditions and untreated clots. The significant increase in the Young's modulus with clotting time is known in the literature, 24,26–28 and was confirmed in our study.…”

Section: Discussionsupporting

confidence: 90%

“…25 The age of blood clots has also been quantitatively related to their rigidity. 24,[26][27][28] An in vivo rabbit model study 27 could successfully separate acute from chronic thrombi with shear wave (SW) elastography. Such results have been less conclusive in humans [29][30][31][32] ; readers may consult a systematic review of clinical studies for details.…”

mentioning

confidence: 99%

“…Early reports related clot aging to their ability to deform under a manually applied probe pressure 25 . The age of blood clots has also been quantitatively related to their rigidity 24,26–28 . An in vivo rabbit model study 27 could successfully separate acute from chronic thrombi with shear wave (SW) elastography.…”

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confidence: 99%

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Effect of rt‐PA on Shear Wave Mechanical Assessment and Quantitative Ultrasound Properties of Blood Clot Kinetics In Vitro

Bosio,

Destrempes,

Roy Cardinal

et al. 2024

J of Ultrasound Medicine

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ObjectiveThe consequences associated with blood clots are numerous and are responsible for many deaths worldwide. The assessment of treatment efficacy is necessary for patient follow‐up and to detect treatment‐resistant patients. The aim of this study was to characterize the effect of treatment on blood clots in vitro using quantitative ultrasound parameters.MethodsBlood from 10 pigs was collected to form three clots per pig in gelatin phantoms. Clots were subjected to 1) no treatment, 2) rt‐PA (recombinant tissue plasminogen activator) treatment after 20 minutes of clotting, and 3) rt‐PA treatment after 60 minutes of clotting. Clots were weighted before and after the experiment to assess the treatment effect by the mass loss. The clot kinetics was studied over 100 minutes using elastography (Young's modulus, shear wave dispersion, and shear wave attenuation). Homodyne K‐distribution (HKD) parameters derived from speckle statistics were also studied during clot formation and dissolving (diffuse‐to‐total signal power ratio and intensity parameters).ResultsTreated clots loosed significantly more mass than non‐treated ones (P < .005). A significant increase in Young's modulus was observed over time (P < .001), and significant reductions were seen for treated clots at 20 or 60 minutes compared with untreated ones (P < .001). The shear wave dispersion differed for treated clots at 60 minutes versus no treatments (P < .001). The shear wave attenuation decreased over time (P < .001), and was different for clots treated at 20 minutes versus no treatments (P < .031). The HKD intensity parameter varied over time (P < .032), and was lower for clots treated at 20 and 60 minutes than those untreated (P < .001 and P < .02).ConclusionThe effect of rt‐PA treatment could be confirmed by a decrease in Young's modulus and HKD intensity parameter. The shear wave dispersion and shear wave attenuation were sensitive to late and early treatments, respectively. The Young's modulus, shear wave attenuation, and HKD intensity parameter varied over time despite treatment.

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

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Effect of rt‐PA on Shear Wave Mechanical Assessment and Quantitative Ultrasound Properties of Blood Clot Kinetics In Vitro

Bosio,

Destrempes,

Roy Cardinal

et al. 2024

J of Ultrasound Medicine

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“…Previous studies have also shown stiffening of blood clots over time 9,12,16,45,46,66–68 . This increase is a characteristic of clot aging.…”

Section: Discussionmentioning

confidence: 78%

“…Previous studies have also shown stiffening of blood clots over time. 9,12,16,45,46,[66][67][68] This increase is a characteristic of clot aging. However, under clinical conditions, patients, once diagnosed, are treated with anticoagulants, and no time-varying trend in Young modulus has been observed.…”

Section: Blood Clot Experimentsmentioning

confidence: 99%

Resonance, Velocity, Dispersion, and Attenuation of Ultrasound‐Induced Shear Wave Propagation in Blood Clot In Vitro Models

Bosio,

Destrempes,

Yazdani

et al. 2023

J of Ultrasound Medicine

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ObjectiveImprove the characterization of mechanical properties of blood clots. Parameters derived from shear wave (SW) velocity and SW amplitude spectra were determined for gel phantoms and in vitro blood clots.MethodsHomogeneous phantoms and phantoms with gel or blood clot inclusions of different diameters and mechanical properties were analyzed. SW amplitude spectra were used to observe resonant peaks. Parameters derived from those resonant peaks were related to mimicked blood clot properties. Three regions of interest were tested to analyze where resonances occurred the most. For blood experiments, 20 samples from different pigs were analyzed over time during a 110‐minute coagulation period using the Young modulus, SW frequency dispersion, and SW attenuation.ResultsThe mechanical resonance was manifested by an increase in the number of SW spectral peaks as the inclusion diameter was reduced (P < .001). In blood clot inclusions, the Young modulus increased over time during coagulation (P < .001). Descriptive spectral parameters (frequency peak, bandwidth, and distance between resonant peaks) were linearly correlated with clot elasticity values (P < .001) with R2 = .77 for the frequency peak, .60 for the bandwidth, and .48 for the distance between peaks. The SW dispersion and SW attenuation reflecting the viscous behavior of blood clots decreased over time (P < .001), mainly in the early stage of coagulation (first minutes).ConclusionThe confined soft inclusion configuration favored SW mechanical resonances potentially challenging the computation of spectral‐based parameters, such as the SW attenuation. The impact of resonances can be reduced by properly selecting the region of interest for data analysis.

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Shear wave ultrasound elastography for estimating cartilage stiffness: implications for early detection of osteoarthritis

Georgas,

Rayes,

Zhang

et al. 2024

Med-X

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Current osteoarthritis (OA) diagnosis relies on radiographic abnormalities found in later stages of the disease, posing a challenge to the treatment efficacy. Therefore, earlier detection of OA is essential for improving therapeutic outcomes. The aim of this study was to investigate the feasibility of shear wave ultrasound elastography (SWUE) to detect changes in cartilage mechanical properties under OA conditions ex-vivo. Bovine osteochondral units were harvested from femoral condyles and subjected to either trypsin degradation, cartilage surface roughness defect using varying degrees of sandpaper, or subchondral bone degeneration using formic acid (FA) injection. Shear waves were generated using a mechanical shaker, while a high-frequency ultrasound system operating at 18 MHz was employed to detect wave propagation along the samples. The elasticity of cartilage was estimated by the shear wave speed (SWS) through the auto-correlation method. Our results show that the estimated SWS of cartilage after 24, 48, and 72 hours of trypsin incubation significantly decreased by 37%, 43%, and 59%, respectively, compared to the control group. Surface roughness treatment using 150-grit sandpaper significantly decreased the SWS by 35% compared to the control. Samples treated with 7% FA showed a significant increase in SWS by 62%, 89%, and 53% compared to control, 1% FA, and 3% FA, respectively. Our findings demonstrate the feasibility of SWUE to differentiate the elastic properties of cartilage under different OA conditions. This study presents the potential of a noninvasive, nonionizing tool for early detection of OA, representing a significant step toward its clinical implementation. Graphical Abstract

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Estimating Thrombus Elasticity by Shear Wave Elastography to Evaluate Ultrasound Thrombolysis for Thrombus With Different Stiffness

Cited by 6 publications

References 50 publications

Effect of rt‐PA on Shear Wave Mechanical Assessment and Quantitative Ultrasound Properties of Blood Clot Kinetics In Vitro

Effect of rt‐PA on Shear Wave Mechanical Assessment and Quantitative Ultrasound Properties of Blood Clot Kinetics In Vitro

Resonance, Velocity, Dispersion, and Attenuation of Ultrasound‐Induced Shear Wave Propagation in Blood Clot In Vitro Models

Shear wave ultrasound elastography for estimating cartilage stiffness: implications for early detection of osteoarthritis

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