Evaluation of Freehand B-Mode and Power-Mode 3D Ultrasound for Visualisation and Grading of Internal Carotid Artery Stenosis

Weinreich, Anna; Karlas, Thomas; Saur, Dorothee

doi:10.1371/journal.pone.0167500

Cited by 15 publications

(14 citation statements)

References 31 publications

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“…This corresponds with recent reports on the application of tomographic US for visualization of homogenous tissue and sharp contrasts, i.e. vascular pathologies [13, 14, 17]. However, the image quality and diagnostic precision in the total patient cohort was rather moderate compared to conventional US.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of a novel tomographic ultrasound device for abdominal examinations

2019

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Conventional ultrasound (US) is the first-line imaging method for abdominal pathologies, but its diagnostic accuracy is operator-dependent, and data storage is usually limited to two-dimensional images. A novel tomographic US system (Curefab CS, Munich, Germany) processes imaging data combined with three-dimensional spatial information using a magnetic field tracking. This enables standardized image presentation in axial planes and a review of the entire examination. The applicability and diagnostic performance of this tomographic US approach was analyzed in an abdominal setting using conventional US as reference. Tomographic US data were successfully compiled in all subjects of a training cohort (20 healthy volunteers) and in 50 patients with abdominal lesions. Image quality (35% and 79% for training and patient cohort respectively) and completeness of organ visualization (45% and 44%) were frequently impaired in tomographic US compared to conventional US. Conventional and tomographic US showed good agreement for measurement of organ sizes in the training cohort (right liver lobe and both kidneys with a median deviation of 5%). In the patient cohort, tomographic US identified 57 of 74 hepatic or renal lesions detected by conventional ultrasound (sensitivity 77%). In conclusion, this study illustrates the diagnostic potential of abdominal tomographic US, but current significant limitations of the tomographic ultrasound device demand further technical improvements before this and comparable approaches can be implemented in clinical practice.

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Section: Discussionsupporting

confidence: 87%

Evaluation of a novel tomographic ultrasound device for abdominal examinations

2019

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“…Carvalho et al 39 developed an algorithm to track the carotid artery lumen centerline, but did not perform segmentation of the lumen. Instead of using B-mode, Power Doppler can be a using in combination with magnetic probe tracking to grade the stenosis of the internal carotid artery, 40 which was not considered in our study. The performance of the algorithm was evaluated using the quality metrics described in Section 2.G.1 and were compared to literature.…”

Section: Discussionmentioning

confidence: 99%

Automated 3D geometry segmentation of the healthy and diseased carotid artery in free‐hand, probe tracked ultrasound images

et al. 2020

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Purpose Rupture of an arterosclerotic plaque in the carotid artery is a major cause of stroke. Biomechanical analysis of plaques is under development aiming to aid the clinician in the assessment of plaque vulnerability. Patient‐specific three‐dimensional (3D) geometry assessment of the carotid artery, including the bifurcation, is required as input for these biomechanical models. This requires a high‐resolution, 3D, noninvasive imaging modality such as ultrasound (US). In this study, a high‐resolution two‐dimensional (2D) linear array in combination with a magnetic probe tracking device and automatic segmentation method was used to assess the geometry of the carotid artery. The advantages of using this system over a 3D ultrasound probe are its higher resolution (spatial and temporal) and its larger field of view. Methods A slow sweep (v = ± 5 mm/s) was made over the subject’s neck so that the full geometry of the bifurcated geometry of the carotid artery is captured. An automated segmentation pipeline was developed. First, the Star‐Kalman method was used to approximate the center and size of the vessels for every frame. Images were filtered with a Gaussian high‐pass filter before conversion into the 2D monogenic signals, and multiscale asymmetry features were extracted from these data, enhancing low lateral wall‐lumen contrast. These images, in combination with the initial ellipse contours, were used for an active deformable contour model to segment the vessel lumen. To segment the lumen–plaque boundary, Otsu’s automatic thresholding method was used. Distension of the wall due to the change in blood pressure was removed using a filter approach. Finally, the contours were converted into a 3D hexahedral mesh for a patient‐specific solid mechanics model of the complete arterial wall. Results The method was tested on 19 healthy volunteers and on 3 patients. The results were compared to manual segmentation performed by three experienced observers. Results showed an average Hausdorff distance of 0.86 mm and an average similarity index of 0.91 for the common carotid artery (CCA) and 0.88 for the internal and external carotid artery. For the total algorithm, the success rate was 89%, in 4 out of 38 datasets the ICA and ECA were not sufficient visible in the US images. Accurate 3D hexahedral meshes were successfully generated from the segmented images . Conclusions With this method, a subject‐specific biomechanical model can be constructed directly from a hand‐held 2D US measurement, within 10 min, with a minimal user input. The performance of the proposed segmentation algorithm is comparable to or better than algorithms previously described in literature. Moreover, the algorithm is able to segment the CCA, ICA, and ECA including the carotid bifurcation in transverse B‐mode images in both healthy and diseased arteries.

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“…In recent years, with the changes in people's living habits and the deepening understanding of posterior circulation ischemia, the age of ischemic stroke onset has gradually become younger. Stenosis of the intracranial vertebral artery is one of the risk factors for posterior circulation ischemia, which can lead to cerebral infarction in the area of the brain supplied with blood by the vertebral artery (7,8). Presently, early diagnosis and treatment of vascular stenotic lesions and ischemic lesions are highly valued in clinical research.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography

Wang¹,

Ma²,

Yang³

et al. 2020

Ann Transl Med

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Background: Currently, no clear diagnostic indicator of vertebral artery hypoplasia (VAH) or intracranial stenosis exists in clinic. This study aims to study the feasibility of neck-brain integrated ultrasound for evaluating stenosis of the intracranial segment in the vertebral artery by comparing with those of computed tomography angiography (CTA) and digital subtraction angiography (DSA). Methods: Clinical data of 138 patients who presented to our hospital with dizziness and headache as the main symptoms between April 2018 and June 2019 were retrospectively analyzed. Patients were divided into observation group and unilateral VAH group. The diagnosing accuracy of ultrasound, CTA, and DAS, the vertebral artery diameter (VAD), blood flow, end diastolic velocity (EDV), peak systolic velocity (PSV) values, resistance indexes (RIs), and difference of RI were compared between the two groups. The sensitivity, specificity and accuracy of ultrasound hemodynamic indicators in assessing stenosis of the intracranial segment of the vertebral artery were calculated.Results: The accuracy rates of mild stenosis and non-stenosis with neck-brain integrated ultrasound were significantly different from those with CTA and DSA examination (P<0.05). The VAD, blood flow, EDV and PSV values of the affected side in the observation group were lower than those of the VAH side in the unilateral VAH group, while the RI and RI difference value were significantly higher than the unilateral VAH group (P<0.05). When the predicted boundary value was 2.084 mm (VAD), 56.41 mL/min (blood flow), 8.47 cm/s (EDV), 0.743 (RI), and 0.149 (difference of RI), the sensitivity and specificity were (86.43%, 49.45%), (88.67%, 47.42%), (80.47%, 68.71%), (82.71%, 84.66%), and (95.84%, 80.11%), respectively.Conclusions: Neck-brain integrated ultrasound is of great value as a noninvasive examination in the diagnosis of stenotic lesions of the internal cervical vertebral artery. VAD, EDV, blood flow, RI, and the difference in RI can be used as indicators to evaluate stenosis of the internal carotid segment of the vertebral artery and provide a reliable basis for the clinical diagnosis of posterior circulation ischemia.

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Evaluation of Freehand B-Mode and Power-Mode 3D Ultrasound for Visualisation and Grading of Internal Carotid Artery Stenosis

Cited by 15 publications

References 31 publications

Evaluation of a novel tomographic ultrasound device for abdominal examinations

Evaluation of a novel tomographic ultrasound device for abdominal examinations

Automated 3D geometry segmentation of the healthy and diseased carotid artery in free‐hand, probe tracked ultrasound images

Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography

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