Ya-Chao Zhao, Yi-Ming He, Fei Wang, Ming-Jun Xu, Da Zhang, Dong-Hai Wang, Mei Zhang
{"title":"Blood Flow Turbulence Measured by High-frame-rate Vector Flow Imaging Conduced to Investigating Advanced Carotid Plaque Vulnerability.","authors":"Ya-Chao Zhao, Yi-Ming He, Fei Wang, Ming-Jun Xu, Da Zhang, Dong-Hai Wang, Mei Zhang","doi":"10.1016/j.ultrasmedbio.2025.05.034","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The high-frame-rate vector flow imaging (V Flow) technique is a simple, practical and feasible quantitative imaging method for detecting hemodynamic parameters of peripheral arteries in healthy people and patients with low carotid stenosis. However, whether V Flow can be used to assess hemodynamic parameters in patients with severe carotid stenosis remains to be illustrated. We sought to investigate the relationship between V Flow-evaluated hemodynamic parameters of advanced carotid stenosis and plaque composition and its value in assessing plaque vulnerability.</p><p><strong>Methods: </strong>Patients undergoing carotid endarterectomy and ultrasound examination were collected, and plaque characteristics were graded on simple semiquantitative scales. Correlations between the turbulence index (Tur) and wall shear stress (WSS) in different parts of plaque and plaque components were analyzed. Receiver operating characteristic curves were used to analyze values of ultrasonic parameters in investigating plaque vulnerability.</p><p><strong>Results: </strong>Tur was more severe in vulnerable plaque than in stable plaque (35.99 ± 26.17 vs 7.82 ± 8.41; p < 0.001). Plaques with severe Tur showed more intraplaque hemorrhage, thrombus, and thinner fibrous cap thickness (p < 0.05 for all). At the upstream sides of carotid stenosis, plaque with a lower mean WSS (meanWSS<sub>upstream</sub>) was associated with decreased fibrous tissue (p = 0.022). At the peak of carotid stenosis, meanWSS (meanWSS<sub>peak</sub>) was higher in the plaques with intraplaque hemorrhage (p = 0.028) and intraplaque neovascularization (p = 0.037). Plaques with a higher oscillatory shear index of WSS had fewer lipid core (p = 0.029) thinner fibrous cap thicknesses (p = 0.004) and more intraplaque neovascularization (p = 0.032). The areas under the curves of carotid intima-media thickness, total plaque area (TPA), Tur, MeanWSS<sub>upstream</sub>, MaxWSS<sub>peak</sub>, MeanWSS<sub>peak,</sub> model 1, model 5 and model 6 for predicting plaque vulnerability were 0.804 (95% confidence interval [CI], 0.650-0.911), 0.886 (95% CI, 0.748-0.964), 0.843 (95% CI, 0.695-0.937), 0.733 (95% CI, 0.571-0.858), 0.677 (95% CI, 0.514-0.815), 0.672 (95% CI, 0.508-0.811), 0.895 (95% CI, 0.759-0.969), 0.973 (95% CI, 0.867-0.999) and 0.930 (95% CI, 0.805-0.986).</p><p><strong>Conclusion: </strong>V Flow-detected hemodynamic parameters were related to plaque components and plaque vulnerability. V Flow has the potential to be an effective tool for investigating patients with severe carotid plaque.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ultrasound in Medicine and Biology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ultrasmedbio.2025.05.034","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ACOUSTICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: The high-frame-rate vector flow imaging (V Flow) technique is a simple, practical and feasible quantitative imaging method for detecting hemodynamic parameters of peripheral arteries in healthy people and patients with low carotid stenosis. However, whether V Flow can be used to assess hemodynamic parameters in patients with severe carotid stenosis remains to be illustrated. We sought to investigate the relationship between V Flow-evaluated hemodynamic parameters of advanced carotid stenosis and plaque composition and its value in assessing plaque vulnerability.
Methods: Patients undergoing carotid endarterectomy and ultrasound examination were collected, and plaque characteristics were graded on simple semiquantitative scales. Correlations between the turbulence index (Tur) and wall shear stress (WSS) in different parts of plaque and plaque components were analyzed. Receiver operating characteristic curves were used to analyze values of ultrasonic parameters in investigating plaque vulnerability.
Results: Tur was more severe in vulnerable plaque than in stable plaque (35.99 ± 26.17 vs 7.82 ± 8.41; p < 0.001). Plaques with severe Tur showed more intraplaque hemorrhage, thrombus, and thinner fibrous cap thickness (p < 0.05 for all). At the upstream sides of carotid stenosis, plaque with a lower mean WSS (meanWSSupstream) was associated with decreased fibrous tissue (p = 0.022). At the peak of carotid stenosis, meanWSS (meanWSSpeak) was higher in the plaques with intraplaque hemorrhage (p = 0.028) and intraplaque neovascularization (p = 0.037). Plaques with a higher oscillatory shear index of WSS had fewer lipid core (p = 0.029) thinner fibrous cap thicknesses (p = 0.004) and more intraplaque neovascularization (p = 0.032). The areas under the curves of carotid intima-media thickness, total plaque area (TPA), Tur, MeanWSSupstream, MaxWSSpeak, MeanWSSpeak, model 1, model 5 and model 6 for predicting plaque vulnerability were 0.804 (95% confidence interval [CI], 0.650-0.911), 0.886 (95% CI, 0.748-0.964), 0.843 (95% CI, 0.695-0.937), 0.733 (95% CI, 0.571-0.858), 0.677 (95% CI, 0.514-0.815), 0.672 (95% CI, 0.508-0.811), 0.895 (95% CI, 0.759-0.969), 0.973 (95% CI, 0.867-0.999) and 0.930 (95% CI, 0.805-0.986).
Conclusion: V Flow-detected hemodynamic parameters were related to plaque components and plaque vulnerability. V Flow has the potential to be an effective tool for investigating patients with severe carotid plaque.
期刊介绍:
Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.