Generic placeholder image

Current Medical Imaging

Author(s): Wenjing Gao, Yinghui Dong, Shaofu Hong, Di Song, Mengmeng Liu, Zhanghong Wei, Yigang Du, Shuangshuang Li, Jinfeng Xu* and Fajin Dong

DOI: 10.2174/1573405620666230327125840

DownloadDownload PDF Flyer Cite As
Feasibility Study of Combining Wall Shear Stress and Elastography to Assess the Vascular Status of Carotid Artery

Article ID: e270323214999 Pages: 7

  • * (Excluding Mailing and Handling)

Abstract

Introduction: At present, early detection of the potential risk of atherosclerosis and prevention is of great significance to reduce the occurrence of stroke.

Aim: This study aims to explore the value of combining the wall shear stress measured by ultrasound vector flow imaging technique and sound touch elastography of common carotid artery in normal adults using the Mindray Resona 7 ultrasound system.

Methods: Forty volunteers (mean age 39.5 y, 23 females, 17 males) were divided into four groups according to their age. All volunteers underwent ultrasound carotid artery examination, and the values of wall shear stress and elasticity on the posterior wall of the common carotid artery were measured using advanced imaging functions, vector flow imaging technique, and sound touch elastography.

Results: Different cut-off values of wall shear stress were used to investigate the significance between two groups with corresponding sound touch elastography values. It can be seen that the statistical difference could be found when the mean wall shear stress was larger than 1.5 Pa approximately (statistical significance was defined when P < 0.05), and the sound touch elastography value was positively correlated with the wall shear stress value.

Conclusion: This study reveals that the combination of wall shear stress and sound touch elastography is an effective and feasible method for assessing carotid artery health. When the mean wall shear stress value is over 1.5 Pa, the corresponding sound touch elastography value increases significantly. The risk of atherosclerosis increases with the stiffness of blood vessel walls.

[1]
Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021; 20(10): 795-820.
[2]
Goddi A, Bortolotto C, Raciti MV, et al. High-frame rate vector flow imaging of the carotid bifurcation in healthy adults: comparison with color doppler imaging. J Ultrasound Med 2018; 37(9): 2263-75.
[3]
Dong Y, Hong S, Song D, et al. Blood flow turbulence quantification of carotid artery with a high-frame rate vector flow imaging. J Ultrasound Med 2022; 42(2): 427-36.
[4]
Zhu Y, Xian X, Wang Z, et al. Research progress on the relationship between atherosclerosis and inflammation. Biomolecules 2018; 8(3): 80.
[5]
Nerem RM. Vascular fluid mechanics, the arterial wall, and atherosclerosis. J Biomech Eng 1992; 114(3): 274-82.
[6]
Qiu Y, Dong Y, Mao F, et al. High-frame rate vector flow imaging technique: Initial application in evaluating the hemodynamic changes of carotid stenosis caused by atherosclerosis. Front Cardiovasc Med 2021; 8: 617391.
[7]
Younis HF, Kaazempur-Mofrad MR, Chan RC, et al. Hemodynamics and wall mechanics in human carotid bifurcation and its consequences for atherogenesis: investigation of inter-individual variation. Biomech Model Mechanobiol 2004; 3(1): 17-32.
[8]
Ophir J, Alam SK, Garra B, et al. Elastography: ultrasonic estimation and imaging of the elastic properties of tissues. Proc Inst Mech Eng H 1999; 213(3): 203-33.
[9]
Pruijssen JT, de Korte CL, Voss I, Hansen HHG. Vascular shear wave elastography in atherosclerotic arteries: A systematic review. Ultrasound Med Biol 2020; 46(9): 2145-63.
[10]
Yiu BYS, Lai SSM, Yu ACH. Vector projectile imaging: time-resolved dynamic visualization of complex flow patterns. Ultrasound Med Biol 2014; 40(9): 2295-309.
[11]
Gatos I, Drazinos P, Yarmenitis S, Theotokas I, Zoumpoulis PS. Comparison of sound touch elastography, shear wave elastography and vibration-controlled transient elastography in chronic liver disease assessment using liver biopsy as the “reference standard”. Ultrasound Med Biol 2020; 46(4): 959-71.
[12]
Zhang L, Dong Y-J, Zhou J-Q, Jia X-H, Li S, Zhan W-W. Similar reproducibility for strain and shear wave elastography in breast mass evaluation: A prospective study using the same ultrasound system. Ultrasound Med Biol 2020; 46(4): 981-91.
[13]
Du Y, Goddi A, Bortolotto C, et al. Wall shear stress measurements based on ultrasound vector flow imaging: Theoretical studies and clinical examples. J Ultrasound Med 2020; 39(8): 1649-64.
[14]
Poloni S, Bozzetto M, Du Y, et al. Velocity vector comparison between vector flow imaging and computational fluid dynamics in the carotid bifurcation. Ultrasonics 2023; 128: 106860.
[15]
Du Y, Ding H, He L, et al. Quantitative blood flow measurements in the common carotid artery: A comparative study of high-frame-rate ultrasound vector flow imaging, pulsed wave doppler, and phase contrast magnetic resonance imaging. Diagnostics (Basel) 2022; 12(3): 690.
[16]
Qiu Y, Yang D, Zhang Q, Chen K, Dong Y, Wang W-P. V Flow technology in measurement of wall shear stress of common carotid arteries in healthy adults: Feasibility and normal values. Clin Hemorheol Microcirc 2020; 74(4): 453-62.
[17]
Zamani M, Skagen K, Scott H, Russell D, Skjelland M. Advanced ultrasound methods in assessment of carotid plaque instability: a prospective multimodal study. BMC Neurol 2020; 20(1): 39.
[18]
Friedman MH, Deters OJ, Bargeron CB, Hutchins GM, Mark FF. Shear-dependent thickening of the human arterial intima. Atherosclerosis 1986; 60(2): 161-71.
[19]
Gnasso A, Irace C, Carallo C, et al. In vivo association between low wall shear stress and plaque in subjects with asymmetrical carotid atherosclerosis. Stroke 1997; 28(5): 993-8.
[20]
Carallo C, Lucca LF, Ciamei M, Tucci S, de Franceschi MS. Wall shear stress is lower in the carotid artery responsible for a unilateral ischemic stroke. Atherosclerosis 2006; 185(1): 108-13.
[21]
Giddens DP, Zarins CK, Glagov S. The role of fluid mechanics in the localization and detection of atherosclerosis. J Biomech Eng 1993; 115(4B): 588-94.
[22]
Gnasso A, Carallo C, Irace C, et al. Association between intima-media thickness and wall shear stress in common carotid arteries in healthy male subjects. Circulation 1996; 94(12): 3257-62.
[23]
Pedersen EM, Oyre S, Agerbaek M, et al. Distribution of early atherosclerotic lesions in the human abdominal aorta correlates with wall shear stresses measured in vivo . Eur J Vasc Endovasc Surg 1999; 18(4): 328-33.
[24]
Reneman RS, Arts T, Hoeks APG. Wall shear stress--an important determinant of endothelial cell function and structure--in the arterial system in vivo. Discrepancies with theory. J Vasc Res 2006; 43(3): 251-69.
[25]
Manbachi A, Hoi Y, Wasserman BA, Lakatta EG, Steinman DA. On the shape of the common carotid artery with implications for blood velocity profiles. Physiol Meas 2011; 32(12): 1885-97.
[26]
Corban MT, Eshtehardi P, Suo J, et al. Combination of plaque burden, wall shear stress, and plaque phenotype has incremental value for prediction of coronary atherosclerotic plaque progression and vulnerability. Atherosclerosis 2014; 232(2): 271-6.
[27]
Malek AM, Alper SL, Izumo S. Hemodynamic shear stress and its role in atherosclerosis. JAMA 1999; 282(21): 2035-42.
[28]
Eshtehardi P, Brown AJ, Bhargava A, et al. High wall shear stress and high-risk plaque: an emerging concept. Int J Cardiovasc Imaging 2017; 33(7): 1089-99.
[29]
Liu Q-Y, Duan Q, Fu X-H, Jiang M, Xia H-W, Wan Y-L. Wall shear stress can improve prediction accuracy for transient ischemic attack. World J Clin Cases 2019; 7(18): 2722-33.