The present disclosure relates to systems and methods for measuring and isolating wave speed within a vessel wall. More particularly, the present disclosure relates to systems and methods for measuring and isolating wave speed within a vessel wall of a generally cylindrical vessel with an imaging system, such as an ultrasound imaging system.
Increased arterial stiffness is associated with increased risk of cardiovascular events. The measurement of the pulse wave velocity (PWV), which is the speed at which the pressure pulse generated from the blood ejection from the left ventricle of the heart travels through the arterial tree, can be used to estimate arterial stiffness. For instance, carotid-femoral PWV (cfPWV), also known as aortic PWV, is considered a “gold standard” measure of arterial stiffness. It is measured by applanation tonometry of the carotid and femoral arteries to obtain pressure waveforms and transit time, and over the surface body measurements are used to estimate the distance the wave has traveled. The cfPWV is related to the Young's modulus, E, of the arterial wall by the Moens-Korteweg equation, cfPWV=√{square root over (Eh/2Rρ)}, where h is the wall thickness, R is the inner radius, and ρ is the density of the blood. The cfPWV is a global measurement or a measurement over a very long segment of the arterial tree. Measuring over a long segment can introduce large bias errors because of inexact knowledge of the true length of the arterial segment over which the wave has traveled.
A more local measurement of PWV can be made using a method call pulse wave imaging (PWI). This method measures the motion of the arterial or heart wall in order to track the wave propagation through the tissue. This method has been utilized in the aortas of mice with and without aneurysms, and in human aortas and carotid arteries. This method has the advantage of assessing the PWV over a short segment (1-9 cm) compared to the longer segment used clinically in cfPWV, which is on the order of tens of centimeters. One limitation of PWI is that only one measurement can be made for each cardiac cycle, so the spatial resolution is higher than traditional cfPWV methods, but the temporal resolution is no better.
Acoustic radiation force has been utilized for perturbing arterial vessels for material characterization. Acoustic Radiation Force Impulse (ARFI) imaging which focuses high intensity ultrasound to displace the tissue has been used to explore localized plaque formations in arterial vessels. Analysis of the displacement amplitude and time course was used in swine models to investigate the ability to localize and classify atherosclerotic plaques. Another method called Supersonic Shear Imaging (SSI) uses focused ultrasound to make propagating shear waves in tissue and has been used to create high frequency propagating waves in human carotid arteries to measure the material properties through the cardiac cycle.
Previous work has used a method called Shearwave Dispersion Ultrasound Vibrometry (SDUV), which uses ultrasound to generate and measure shear waves in soft tissues and analyze the shear wave velocity dispersion to extract viscoelastic material properties. It used acoustic radiation force in tubes and ex vivo arteries to produce high frequency waves (100-500 Hz) in the wall of the tube or vessel to investigate the material properties, similar to the application of the SDUV method in large organs.
The artery's material properties are known to be anisotropic. This has been established by many studies that have examined ex vivo arteries after being cut using biaxial testing to evaluate the behavior of the artery in the longitudinal and circumferential directions. An in vivo study in rats demonstrated biaxial testing of carotid artery passive and active stiffness and the variation with age of the rats. Both the biaxial passive and active stiffness increased in rats evaluated at 6 and 23 months.
Therefore, it would be desirable to have a system and method for measuring and reporting material properties of a vessel in vivo.
The present disclosure overcomes the aforementioned drawbacks by providing systems and methods for measuring wave speeds in substantially cylindrical vessels. Systems and methods described herein are suitable for measuring and isolating a wave speed within a vessel wall of a substantially cylindrical vessel by isolating the longitudinal and circumferential wave speeds in the substantially cylindrical vessel to determine material properties of the vessel using the isolated wave speeds.
In accordance with the present disclosure, the method of measuring and isolating a wave speed within a vessel wall of a substantially cylindrical vessel using an ultrasound imaging system, the vessel having a longitudinal axis and a circumference that is orthogonal to the longitudinal axis, the method includes measuring, using a first transducer of the ultrasound imaging system, a motion of the vessel wall at a first location on the circumference, the vessel wall experiencing a propagating longitudinal wave along the longitudinal axis and a propagating circumferential wave about the circumference. The method also includes measuring, using the first transducer or a second transducer of the ultrasound imaging system, a motion of the vessel wall at a second location on the circumference. The first and second location can be positioned substantially opposite one another on the circumference. The method also includes isolating a circumferential wave speed of the propagating circumferential wave by computationally analyzing, using a processor of the ultrasound imaging system, a difference between the motion of the vessel wall at the first location and the motion of the vessel wall at the second location. The method also includes generating a report indicating material properties of the vessel using the longitudinal or circumferential wave speeds.
In accordance with the present disclosure, the method of measuring and isolating a wave speed within a vessel wall of a substantially cylindrical vessel using a motion imaging system, the vessel having a longitudinal axis and a circumference that is orthogonal to the longitudinal axis, the method includes inducing a propagating longitudinal wave within the vessel wall along the longitudinal axis and a propagating circumferential wave within the vessel wall about the circumference. The method also includes measuring, using a first motion detector of the motion imaging system, a motion of the vessel wall at a first location on the circumference. The method also includes measuring, using the first motion detector or a second motion detector of the motion imaging system, a motion of the vessel wall at a second location on the circumference, the first and second location are positioned substantially opposite one another on the circumference. The method also includes isolating a circumferential wave speed of the propagating circumferential wave by Fourier transforming a difference between the motion of the vessel wall at the first location and the motion of the vessel wall at the second location. The method also includes generating a report using the longitudinal or circumferential wave speeds.
The foregoing and other aspects and advantages of the invention will appear from the following description. In the description, reference is made to the accompanying drawings that form a part hereof, and in which there is shown by way of illustration a preferred embodiment of the invention. Such embodiment does not necessarily represent the full scope of the invention, however, and reference is made therefore to the claims and herein for interpreting the scope of the invention.
This disclosure provides methods of measuring and isolating a wave speed within a wall of a vessel, such as a bodily lumen or other tubular structure, using a motion imaging system. As an example, a bodily lumen can include a blood vessel, the esophagus, a section of the gastrointestinal tract, or the like.
Referring particularly to
When energized by a transmitter 106, each transducer element 104 produces a burst of ultrasonic energy. The ultrasonic energy reflected back to the transducer array 102 from the object or subject under study is converted to an electrical signal by each transducer element 104 and applied separately to a receiver 108 through a set of switches 110. The transmitter 106, receiver 108, and switches 110 are operated under the control of a digital controller 112 responsive to commands input by a user. A complete scan is performed by acquiring a series of echo signals in which the switches 110 are set to their transmit position, thereby directing the transmitter 106 to be turned on momentarily to energize each transducer element 104. The switches 110 are then set to their receive position and the subsequent echo signals produced by each transducer element 104 are measured and applied to the receiver 108. The separate echo signals from each transducer element 104 are combined in the receiver 108 to produce a single echo signal that is employed to produce a line in an image, for example, on a display system 114.
The present disclosure recognizes that motion imaging using a system such as described with respect to
The methods may include one or more of the following: inducing a propagating longitudinal wave within a vessel wall along a longitudinal axis; inducing a propagating circumferential wave within a vessel wall about a circumference that is orthogonal to the longitudinal axis; measuring a motion of a vessel wall at a first location on the circumference; measuring a motion of the vessel wall at a second location on the circumference, the first location and second location are positioned substantially opposite one another on the circumference; isolating the circumferential wave speed of the propagating circumferential wave; isolating the longitudinal wave speed of the propagating longitudinal wave; and generating a report using the circumferential wave speed or the longitudinal wave speed.
In particular, referring to
At process block 120, a propagating longitudinal wave within the vessel wall along the longitudinal axis and a propagating circumferential wave within the vessel wall about the circumference are optionally induced. In certain aspects, the methods do not require inducing the propagating waves, because the vessel may already contain propagating waves. For example, in some instances intrinsic physiological motion will generate longitudinal and circumferential waves in a vessel or other bodily vessel. As one example, pulsatile blood flow can induce longitudinal and circumferential waves in the wall of a blood vessel. As another example, swallowing can induce longitudinal and circumferential waves in the wall of the esophagus. In certain configurations, the propagating waves may also be induced by a force inducing element of the ultrasound imaging system, such as by generating ultrasound with a transducer.
In certain aspects, the propagating waves are induced by delivering a force to the vessel. In certain aspects, the force that is delivered is a force that induces shear strain.
In certain aspects, the propagating waves are induced by an acoustic radiation force, an external vibration, or a combination thereof. Acoustic radiation force and external vibration each has their advantages in terms of frequency bandwidth, ease of application, signal-to-noise ratio, and modal vibration, among others. Acoustic radiation force can provide a targeted, high bandwidth wave, but can be limited in motion amplitude. External vibration can provide large motion and does not require any high power pulses from an ultrasound transducer for generation of the wave, but does require a component that is external to the transducer.
The acoustic radiation force can be focused or unfocused. The radiation force can also be generated using one or more beams. The acoustic radiation force can be distributed at different locations along the vessel wall. In aspects where the acoustic radiation force is focused, the force can be applied at a force push location on the vessel wall. The force push location can be located on the circumference and can be located at the first location, second location, third location, or fourth location. In certain aspects, multiple beams of acoustic radiation force can be applied at multiple locations along the longitudinal direction.
The force can be applied with any waveform that a person having ordinary skill in the art would recognize as suitable for imaging applications, such as a pure sinusoidal waveform, a chirped waveform, a waveform where the frequency varies over time, combinations thereof, and the like. The motion imaging system can further comprise a pulse generator for designing and executing waveforms.
The force inducing element can include a transducer of an ultrasound imaging system, a linear actuator, such as a speaker, an electromechanical shaker, or a source of vibrations, or a combination thereof. In certain aspects, the force inducing element is located within the first or second transducer.
In some aspects, longitudinal and circumferential waves are induced in a vessel wall using one or more unfocused ultrasound push beams that are optimized to produce and isolate circumferential waves. To isolate the circumferential wave, it is important to cancel out the bending wave or anti-symmetric motion. To achieve this, the motion induced in the vessel has to be similar on the near-side and far-side vessel walls in order for the subtraction to leave only the circumferential motion. Preferably, both walls would be stimulated with a similar force to produce an anti-symmetric amplitude that is equal in each wall.
Referring to
In some instances an unfocused push beam might not be strong enough to generate similar motion in both the near-side and far-side vessel walls. Thus, as illustrated in
In some other embodiments, a single focused ultrasound beam can be used to simultaneously excite the near-side vessel wall 152 and the far-side vessel wall 154, as illustrated in
For redundancy and robustness, any of the different push schemes (e.g., unfocused beam, single focused beam, dual-depth focused beam methods) can be implemented at different lateral locations in a simultaneous fashion. An example of this is illustrated in
Referring again to
In certain aspects, the methods comprise measuring a motion of the vessel wall at a first location on the circumference. Measuring the motion at the first location can be done using a first motion sensor of a motion imaging system or a first transducer of an ultrasound imaging system.
In certain aspects, the methods comprise measuring a motion of the vessel wall at a second location on the circumference. Measuring the motion on the second location can be done using the first motion sensor or the first transducer. Alternatively, measuring the motion on the second location can be done using a second motion sensor of the motion imaging system of a second transducer of the ultrasound imaging system. The methods may further comprise measuring a motion of the vessel wall at additional locations on the vessel, on the circumference or elsewhere along the longitudinal axis.
It should be appreciated that motion data should be acquired on a timescale that allows sufficient sampling of the propagating waves. In other words, the motion data should be acquired on a timescale that precludes undersampling of the propagating waves.
In certain aspects, the methods comprise measuring a motion of the vessel wall at a third and fourth location on the circumference.
In certain aspects, the motion of the vessel is measured over no more than about 10 cm of length of the vessel along the longitudinal direction.
The methods may further comprise selecting the first location and second location based on a geometry of the vessel. In certain aspects, the geometry of the vessel is measured using an imaging system, such as an ultrasound imaging system, a magnetic resonance imaging system, an optical imaging system, or a combination thereof. In certain aspects, the geometry may be measured, estimated, calculated, or the like.
At process block 124, longitudinal and/or circumferential wave speeds are isolated.
In certain aspects, the methods comprise isolating a circumferential wave speed of the propagating circumferential wave. Isolating the circumferential wave speed may comprise computationally analyzing or Fourier transforming a difference between the motion of the vessel wall at the first location and the motion of the vessel wall at the second location.
In certain aspects, the methods comprise isolating a longitudinal wave speed of the propagating longitudinal wave. Isolating the longitudinal wave speed may comprise using a time of flight based technique, using a Radon transform based technique, or using a Fourier transform based technique. In certain aspects, isolating the longitudinal wave speed may comprise Fourier transforming the sum of the motion of the vessel wall at the first location and the motion of the vessel wall at the second location.
In certain aspects, the methods comprise determining a material or mechanical property of the vessel using the circumferential wave speed or the longitudinal wave speed. The material properties can include density, elasticity, viscosity, stiffness, anisotropy, and the like.
In certain aspects, the methods comprise determining an anisotropy of the vessel using the circumferential wave speed or the longitudinal wave speed.
At process block 126, a report may be generated. The report may use the circumferential wave speed, the longitudinal wave speed, a material property of the vessel, or a combination thereof. It should be appreciated that use in the report does not need to be direct use in the report, and can include use in a computation whose result is provided in the report, use directly in the report, use in making a determination, prognostication, or categorization that is provided in the report, and the like.
In certain aspects, the substantially cylindrical vessel is a synthetic tube, a blood vessel, an esophagus, a section of the gastrointestinal tract, or the like. In certain aspects, the substantially cylindrical vessel is suspended within an external medium, such as human tissue, a gel, or the like. In certain aspects, the substantially cylindrical vessel can contain a gas, such as a pressurized gas, or a fluid or solid medium, such as blood, water, saline, a gel, or the like, within the vessel.
In certain aspects, the transducers may be linear array transducers. In certain aspects, measuring at a location may comprise measuring over a longitudinal section of the vessel wall that includes the location. In certain aspects, measuring at a location may comprise measuring over a circumferential section of the circumference.
In certain aspects, the methods further comprise confirming the presence of the propagating circumferential wave of the propagating longitudinal wave. Confirming can include measuring, using the motion imaging system, a motion of the vessel wall at the third location and a motion of the vessel wall at the fourth location on the circumference. The motion of the vessel wall at the first location and the motion of the vessel wall at the second location can be measured by the first motion detector of the motion imaging system or the first transducer of the ultrasound imaging system. The motion of the vessel wall at the third location and the motion of the vessel wall at the fourth location can be measured by the second motion detector of the motion imaging system or the second transducer of the ultrasound imaging system.
In certain aspects, the methods further comprise measuring a phase velocity of the propagating waves. The phase velocity may be measured using a Fourier transform based technique.
An external vibration source can be applied to skin to induce motion in the underlying tissue including the arterial wall. The external vibration can be a pure sinusoidal tone or a simultaneous combination of sinusoidal tones, or a more complicated signal such as a chirp, a signal that changes frequency through time. The actuator could be a small speaker or some other vibrating source such as an electromechanical shaker. The arterial wave motion can be assessed using ultrasound-based techniques using focused or unfocused beams at a sufficient frame rate to capture the frequency content of the external vibration. Analysis similar to that detailed above could be used. Additionally, data analysis using phase-based techniques utilizing Fourier transforms and moving windows through time can be used to measure the phase at a given frequency or over a specified bandwidth. A two-dimensional Fourier transform of the spatiotemporal data can be used to directionally filter the data as well as analyze wave velocities.
Acoustic radiation force was used to generate propagating waves in the wall of rubber tubes and an excised porcine carotid artery and measured the wave motion using compounded plane wave imaging. To study the tubes, two Verasonics systems equipped with linear array transducers (L7-4, Philips Healthcare, Andover, Mass.) were used.
The transducers were placed at 90° with respect to each other to obtain different views along the tube wall (
The presence of circumferential waves was confirmed by pushing on a tube with one transducer and measuring with the same transducer and another transducer oriented at 90° (
One way to isolate this symmetric mode for analysis is to subtract the wall motion from the two walls measured by a single transducer. This operation cancels motion that is in-phase, i.e., asymmetric motion, and will emphasize the motion that is out-of-phase, symmetric motion. To illustrate this the sum (
A method was performed that can extract information about both the longitudinal and circumferential wave speeds in tubes and arteries. It was first observed through a unique experimental design that both the longitudinal and circumferential waves could be induced with a focused radiation force beam. It was also observed that asymmetric motion from the transducer that was the source of the push force and symmetric motion orthogonal to the push transducer. The method of subtracting motion from both walls was used to isolate the symmetric behavior and then Fourier techniques were used to obtain information about the circumferential wave speeds.
The longitudinal and circumferential wave speeds were measured in two custom-made tubes and the speeds were compared assuming isotropicity of the material. The results from the first tube at three different transmural pressures matched very well. The second tube had a linear correlation between the c1 and cc values but the cc values were biased high.
Lastly, the values of c1 and cc were measured as the vessel was pressurized from 20 to 200 mmHg and then depressurized back to 20 mmHg, and the results are shown in
The present invention has been described in terms of one or more preferred embodiments, and it should be appreciated that many equivalents, alternatives, variations, and modifications, aside from those expressly stated, are possible and within the scope of the invention.
This application claims priority to U.S. Provisional Patent Application No. 62/030,109, filed Jul. 29, 2014, the entire contents of which are incorporated herein in their entirety by reference.
This invention was made with government support under EB002640 awarded by the National Institutes of Health. The government has certain rights in the invention.
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/US2015/042718 | 7/29/2015 | WO | 00 |
Number | Date | Country | |
---|---|---|---|
62030109 | Jul 2014 | US |