Super-Resolution Ultrasound Imaging Using the Erythrocytes—Part II: Velocity Images

Super-resolution ultrasound imaging using the erythrocytes (SURE) has recently been introduced. The method uses erythrocytes as targets instead of fragile microbubbles (MBs). The abundance of erythrocyte scatterers makes it possible to acquire SURE data in just a few seconds compared with several minutes in ultrasound localization microscopy (ULM) using MBs. A high number of scatterers can reduce the acquisition time; however, the tracking of uncorrelated and high-density scatterers is quite challenging. This article hypothesizes that it is possible to detect and track erythrocytes as targets to obtain vascular flow images. A SURE tracking pipeline is used with modules for beamforming, recursive synthetic aperture (SA) imaging, motion estimation, echo canceling, peak detection, and recursive nearest-neighbor (NN) tracker. The SURE tracking pipeline is capable of distinguishing the flow direction and separating tubes of a simulated Field II phantom with 125–25- $\mu \text { m}$ wall-to-wall tube distances, as well as a 3-D printed hydrogel micr-flow phantom with 100–60- $\mu \text { m}$ wall-to-wall channel distances. The comparison of an in vivo SURE scan of a Sprague-Dawley rat kidney with ULM and micro-computed tomography (CT) scans with voxel sizes of 26.5 and $5~\mu \text { m}$ demonstrated consistent findings. A microvascular structure composed of 16 vessels exhibited similarities across all imaging modalities. The flow direction and velocity profiles in the SURE scan were found to be concordant with those from ULM.