Contrast Enhanced Ultrasound Perfusion Imaging in Skeletal Muscle

Nguyen, TheAnh; Davidson, Brian P.

doi:10.4250/jcvi.2019.27.e31

Cited by 17 publications

(10 citation statements)

References 56 publications

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“…US is useful in evaluating soft tissues and is almost comparable to MRI in detecting periprosthetic collections (16). Its value in assessing muscle edema and vascularization (37,38) has never been evaluated in the context of PJI, and evaluation of deep alterations can be challenging. CT, however, was shown by Cyteval et al (17) to be sensitive and specific when at least one soft-tissue abnormality (joint distention, fluid-filled bursae, or fluid collections) was used to diagnose PJI.…”

Section: Interobserver Agreementmentioning

confidence: 99%

Diagnosis of Periprosthetic Hip Joint Infection Using MRI with Metal Artifact Reduction at 1.5 T

et al. 2020

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Background MRI with metal artifact reduction has gained importance in assessment of pain with total hip arthroplasty (THA). However, its role in diagnosis of periprosthetic joint infection (PJI) has not been well defined. Purpose To evaluate findings of PJI after THA and to determine the diagnostic performance of 1.5-T MRI with metal artifact reduction. Materials and Methods Dedicated compressed sensing-based slice encoding for metal artifact correction 1.5-T MRI examinations (from January 2015 to April 2018) in patients with THA PJI (infection group) and noninfected THA (control group) were retrospectively evaluated by two musculoskeletal radiologists. Fisher exact test was used to compare the groups. Sensitivity, specificity, and accuracy were evaluated for each finding. Interobserver reliability was assessed with statistics. Results Forty patients (mean age, 69 years ± 11 [standard deviation]; 26 men) in the infection group and 100 patients (mean age, 67 years ± 11; 42 men) in the control group were evaluated. Periosteal reaction, capsule edema, and intramuscular edema differed between the two groups (P < .001 for each finding). Periosteal reaction was found in 31 of 40 patients with infection and 10 of 100 participants in the control group (sensitivity, 78%; specificity, 90%; accuracy, 86%); capsule edema was found in 33 of 40 (infection group) and five of 100 (control group) (sensitivity, 83%; specificity, 95%; accuracy, 91%); and intramuscular edema was found in 38 of 40 (infection group) and 14 of 100 (control group) (sensitivity, 95%; specificity, 86%; accuracy, 89%). Interobserver agreement was almost perfect, with values between 0.88 and 0.92. No difference between the two groups was found regarding the presence of osteolysis (infection group, 23 of 40; control group, 60 of 100), bone marrow edema (39 of 40 vs 87 of 100), effusion (20 of 40 vs 26 of 100), abductor tendon lesion (22 of 40 vs 62 of 100), or bursitis (14 of 40 vs 34 of 100) (P > .05 for each finding). Conclusion The presence of periosteal reaction, capsule edema, and intramuscular edema after total hip arthroplasty at 1.5-T MRI with metal artifact reduction had a high accuracy in evaluation of periprosthetic joint infection. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Zanetti in this issue.

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Section: Interobserver Agreementmentioning

confidence: 99%

Diagnosis of Periprosthetic Hip Joint Infection Using MRI with Metal Artifact Reduction at 1.5 T

et al. 2020

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“…Conventional techniques to evaluate PAD are of limited ability to estimate diffuse or small vessel disease, or microvascular dysfunction, which are fundamental aspects of the pathophysiology of PAD. 23 Clinical studies have shown that perfusion imaging can evaluate PAD severity. 24 In a study of patients with PAD, perfusion deficits in the calf muscles and disease severity were determined by contrast‐enhanced ultrasound.…”

Section: Discussionmentioning

confidence: 99%

“… 25 A previous study showed that patients with PAD with intermittent claudication compared with controls had lower peak exercise perfusion and lower limb perfusion. 23 Moreover, patients with PAD and diabetes were found to have poor tissue perfusion and flow impairment attributable to microvascular dysfunction. Perfusion imaging by contrast‐enhanced ultrasound showed patients with diabetes with microvascular complications had reduced capillary volume recruitment.…”

Section: Discussionmentioning

confidence: 99%

“…Perfusion imaging by contrast‐enhanced ultrasound showed patients with diabetes with microvascular complications had reduced capillary volume recruitment. 23 , 26 Muscle microvascular blood flow, oxygenation, and pH can act as surrogate markers for perfusion pressure. Previous studies showed that increased intramuscular pressure is associated with a significant decrease in muscle microvascular blood flow, oxygenation, pH, and perfusion pressure in the leg.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic Resonance Imaging‐Derived Microvascular Perfusion Modeling to Assess Peripheral Artery Disease

Gimnich

Belousova

Short

et al. 2023

JAHA

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Background Computational fluid dynamics has shown good agreement with contrast‐enhanced magnetic resonance imaging measurements in cardiovascular disease applications. We have developed a biomechanical model of microvascular perfusion using contrast‐enhanced magnetic resonance imaging signal intensities derived from skeletal calf muscles to study peripheral artery disease (PAD). Methods and Results The computational microvascular model was used to study skeletal calf muscle perfusion in 56 individuals (36 patients with PAD, 20 matched controls). The recruited participants underwent contrast‐enhanced magnetic resonance imaging and ankle‐brachial index testing at rest and after 6‐minute treadmill walking. We have determined associations of microvascular model parameters including the transfer rate constant, a measure of vascular leakiness; the interstitial permeability to fluid flow which reflects the permeability of the microvasculature; porosity, a measure of the fraction of the extracellular space; the outflow filtration coefficient; and the microvascular pressure with known markers of patients with PAD. Transfer rate constant, interstitial permeability to fluid flow, and microvascular pressure were higher, whereas porosity and outflow filtration coefficient were lower in patients with PAD than those in matched controls (all P values ≤0.014). In pooled analyses of all participants, the model parameters (transfer rate constant, interstitial permeability to fluid flow, porosity, outflow filtration coefficient, microvascular pressure) were significantly associated with the resting and exercise ankle‐brachial indexes, claudication onset time, and peak walking time (all P values ≤0.013). Among patients with PAD, interstitial permeability to fluid flow, and microvascular pressure were higher, while porosity and outflow filtration coefficient were lower in treadmill noncompleters compared with treadmill completers (all P values ≤0.001). Conclusions Computational microvascular model parameters differed significantly between patients with PAD and matched controls. Thus, computational microvascular modeling could be of interest in studying lower extremity ischemia.

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“…Die muskuläre Perfusion unterliegt daher einer strengen Regulierung, die für die gesamte kardiometabolische Gesundheit lebensnotwendig ist. Der Blutfluss variiert dabei von 20 % des Herzzeitvolumens (HZV) in Ruhe bis zu 80 % während körperlicher Anstrengung, wobei Höchstwerte von bis zu 50-60 ml/ 100g/ min erreicht werden können [20][21][22]. Zusammengefasst wurde gezeigt, dass die Skelettperfusion in der Lage ist, sich um das 100-fache, ausgehend von Ruhebedingungen, zu erschöpfender, zyklischer Muskelarbeit zu steigern [21,23].…”

Section: Physiologieunclassified