Blood flow patterns estimation in the left ventricle with low-rate 2D and 3D dynamic contrast-enhanced ultrasound.


Journal

Computer methods and programs in biomedicine
ISSN: 1872-7565
Titre abrégé: Comput Methods Programs Biomed
Pays: Ireland
ID NLM: 8506513

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 20 07 2020
accepted: 14 10 2020
pubmed: 22 11 2020
medline: 15 5 2021
entrez: 21 11 2020
Statut: ppublish

Résumé

Left ventricle (LV) dysfunction always occurs at early heart-failure stages, producing variations in the LV flow patterns. Cardiac diagnostics may therefore benefit from flow-pattern analysis. Several visualization tools have been proposed that require ultrafast ultrasound acquisitions. However, ultrafast ultrasound is not standard in clinical scanners. Meanwhile techniques that can handle low frame rates are still lacking. As a result, the clinical translation of these techniques remains limited, especially for 3D acquisitions where the volume rates are intrinsically low. To overcome these limitations, we propose a novel technique for the estimation of LV blood velocity and relative-pressure fields from dynamic contrast-enhanced ultrasound (DCE-US) at low frame rates. Different from other methods, our method is based on the time-delays between time-intensity curves measured at neighbor pixels in the DCE-US loops. Using Navier-Stokes equation, we regularize the obtained velocity fields and derive relative-pressure estimates. Blood flow patterns were characterized with regard to their vorticity, relative-pressure changes (dp/dt) in the LV outflow tract, and viscous energy loss, as these reflect the ejection efficiency. We evaluated the proposed method on 18 patients (9 responders and 9 non-responders) who underwent cardiac resynchronization therapy (CRT). After CRT, the responder group evidenced a significant (p<0.05) increase in vorticity and peak dp/dt, and a non-significant decrease in viscous energy loss. No significant difference was found in the non-responder group. Relative feature variation before and after CRT evidenced a significant difference (p<0.05) between responders and non-responders for vorticity and peak dp/dt. Finally, the method feasibility is also shown with 3D DCE-US. Using the proposed method, adequate visualization and quantification of blood flow patterns are successfully enabled based on low-rate DCE-US of the LV, facilitating the clinical adoption of the method using standard ultrasound scanners. The clinical value of the method in the context of CRT is also shown.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Left ventricle (LV) dysfunction always occurs at early heart-failure stages, producing variations in the LV flow patterns. Cardiac diagnostics may therefore benefit from flow-pattern analysis. Several visualization tools have been proposed that require ultrafast ultrasound acquisitions. However, ultrafast ultrasound is not standard in clinical scanners. Meanwhile techniques that can handle low frame rates are still lacking. As a result, the clinical translation of these techniques remains limited, especially for 3D acquisitions where the volume rates are intrinsically low.
METHODS METHODS
To overcome these limitations, we propose a novel technique for the estimation of LV blood velocity and relative-pressure fields from dynamic contrast-enhanced ultrasound (DCE-US) at low frame rates. Different from other methods, our method is based on the time-delays between time-intensity curves measured at neighbor pixels in the DCE-US loops. Using Navier-Stokes equation, we regularize the obtained velocity fields and derive relative-pressure estimates. Blood flow patterns were characterized with regard to their vorticity, relative-pressure changes (dp/dt) in the LV outflow tract, and viscous energy loss, as these reflect the ejection efficiency.
RESULTS RESULTS
We evaluated the proposed method on 18 patients (9 responders and 9 non-responders) who underwent cardiac resynchronization therapy (CRT). After CRT, the responder group evidenced a significant (p<0.05) increase in vorticity and peak dp/dt, and a non-significant decrease in viscous energy loss. No significant difference was found in the non-responder group. Relative feature variation before and after CRT evidenced a significant difference (p<0.05) between responders and non-responders for vorticity and peak dp/dt. Finally, the method feasibility is also shown with 3D DCE-US.
CONCLUSIONS CONCLUSIONS
Using the proposed method, adequate visualization and quantification of blood flow patterns are successfully enabled based on low-rate DCE-US of the LV, facilitating the clinical adoption of the method using standard ultrasound scanners. The clinical value of the method in the context of CRT is also shown.

Identifiants

pubmed: 33218707
pii: S0169-2607(20)31643-6
doi: 10.1016/j.cmpb.2020.105810
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105810

Informations de copyright

Copyright © 2020. Published by Elsevier B.V.

Auteurs

Peiran Chen (P)

Department of Electrical Engineering, Eindhoven University of Technology, Netherlands. Electronic address: p.chen1@tue.nl.

Ruud J G van Sloun (RJG)

Department of Electrical Engineering, Eindhoven University of Technology, Netherlands.

Simona Turco (S)

Department of Electrical Engineering, Eindhoven University of Technology, Netherlands.

Hessel Wijkstra (H)

Department of Electrical Engineering, Eindhoven University of Technology, Netherlands; Department of Urology, Amsterdam University Medical Centers, Netherlands.

Domenico Filomena (D)

Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, Sapienza University of Rome, Italy.

Luciano Agati (L)

Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, Sapienza University of Rome, Italy.

Patrick Houthuizen (P)

Department of Cardiology, Catharina Hospital, Netherlands.

Massimo Mischi (M)

Department of Electrical Engineering, Eindhoven University of Technology, Netherlands.

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