Biomedical subjects

Frits Mastik

Publications and source records attributed to Frits Mastik.

23 records · Page 2Linked to original sources

PubMed2003

Intravascular elastography: from bench to bedside.

An unstable lesion may rupture and cause an acute thrombotic reaction. These lesions contain a large lipid pool covered by a thin fibrous cap. The stress in the cap increased with decreasing thickness and increasing macrophage infiltration. Intravascular ultrasound (IVUS) elastography might be an ideal technique to assess the presence of lipid pools and identify high stress regions. Elastography assesses the local mechanical properties of tissue using its deformation caused by the intraluminal pressure. The technique was validated in vitro using diseased human coronary and femoral arteries. These experiments demonstrated that the strain in the three plaque types is different (P < 0.001). Especially between fibrous and fatty tissue, a highly significant difference (P = 0.0012) was found. Additionally, the predictive value for identifying the vulnerable plaque was investigated. A high strain region at the lumen vessel wall boundary has 88% sensitivity and 89% specificity for identifying these plaques. In vivo, the technique is validated in an atherosclerotic Yucatan mini-pig animal model. This study also revealed higher strain values in fatty than fibrous plaques (P < 0.001). The presence of a high strain region at the lumen plaque interface has a high predictive value for identifying macrophages. Patient studies revealed high strain values (1-2%) in soft plaques. Calcified material shows low strain values (0-0.2%). With the development of three-dimensional elastography, identification of weak spots over the full length of a coronary artery becomes possible. In conclusion, intravascular elastography is a unique tool to assess lesion composition and vulnerability. The development of three-dimensional elastography provides a technique that may develop into a clinical available tool for identifying the rupture-prone plaque.

Animals↗

PubMed2002

Identification of atherosclerotic plaque components with intravascular ultrasound elastography in vivo: a Yucatan pig study.

BACKGROUND: Intravascular ultrasound elastography assesses the local strain of the atherosclerotic vessel wall. In the present study, the potential to identify different plaque components in vivo was investigated. METHODS AND RESULTS: Atherosclerotic external iliac and femoral arteries (n=24) of 6 Yucatan pigs were investigated. Before termination, elastographic data were acquired with a 20-MHz Visions catheter. Two frames acquired at end-diastole with a pressure differential of approximately 4 mm Hg were acquired to obtain the elastograms. Before dissection, x-ray was used to identify the arterial segments that had been investigated by ultrasound. Specimens were stained for collagen, fat, and macrophages. Plaques were classified as absent, early fibrous lesion, early fatty lesion, or advanced fibrous plaque. The average strains in the plaque-free arterial wall (0.21%) and the early (0.24%) and advanced fibrous plaques (0.22%) were similar. Higher average strain values were observed in fatty lesions (0.46%) compared with fibrous plaques (P=0.007). After correction for confounding by lipid content, no additional differences in average strain were found between plaques with and without macrophages (P=0.966). Receiver operating characteristic analysis revealed a sensitivity and a specificity of 100% and 80%, respectively, to identify fatty plaques. The presence of a high-strain spot (strain >1%) has 92% sensitivity and 92% specificity to identify macrophages. CONCLUSIONS: To the best of our knowledge, this is the first time that intravascular ultrasound elastography has been validated in vivo. Fatty plaques have an increased mean strain value. High-strain spots are associated with the presence of macrophages.

Animals↗

PubMed2002

IVUS flow measurements: line spread function and decorrelation pattern.

A method to measure transverse blood flow, based on correlation between consecutive radio frequency (RF) signals, has been developed. Currently, we are implementing the method for an intravascular (IVUS) array catheter. In this paper, the acoustical beam (line-spread function, LSF) was experimentally measured and compared with the simulated one. Next, the experimental LSF(E) was convolved with a matrix of white noise to produce RF(E) signals. Decorrelation pattern from the RF(E) signals was compared with the correspondent autoconvolution of the LSF(E) and a good agreement was found. We conclude that the transverse decorrelation pattern of the IVUS array catheter can be assessed from the properties of the acoustical beam.

Ultrasonography, Interventional↗

PubMed2002

Dynamic noise correction for IVUS quantitative volume blood flow: methods and numerical validation.

In recent years, a new method to measure transverse blood flow based on the decorrelation of the radio-frequency (RF) signals, has been developed. Transverse blood flow estimation may be influenced by noise. In this paper, we investigated a new correlation-based method for noise correction. The decorrelation characteristics of transverse blood flow using an intravascular ultrasound (US) or IVUS array catheter were studied by means of computer modeling. Blood was simulated as a collection of randomly located point scatterers; moving this scattering medium transversely across the acoustical beam represented flow. Parabolic blood flow was simulated. Additive noise was added to the RF signals at a given signal-to-noise ratio (SNR). Next, a new method to dynamically estimate and suppress the decorrelation due to noise is presented. The decorrelation due to noise was estimated from the correlation coefficients from flowing blood obtained at increasing time lags. The correlation graphs are corrected for the decorrelation due to noise, leaving the decorrelation due to blood flow. The method shows promise to estimate and correct the correlation coefficients for noise.

Blood Flow Velocity↗

PubMed2002

Decorrelation-based blood flow velocity estimation: effect of spread of flow velocity, linear flow velocity gradients, and parabolic flow.

In recent years, a new method to measure transverse blood flow, based on the decorrelation of the radio frequency (RF) signals has been developed. In this paper, we investigated the influence of nonuniform flow on the velocity estimation. The decorrelation characteristics of transverse blood flow using an intravascular ultrasound (IVUS) array catheter are studied by means of computer modeling. Blood was simulated as a collection of randomly located point scatterers; moving this scattering medium transversally across the acoustical beam represented flow. First-order statistics were evaluated, and the signal-to-noise ratio from the signals were measured. The correlation coefficient method was used to present the results. Three velocity profiles were simulated: random spread of blood-flow velocity, linear blood-flow velocity gradient, and parabolic blood-flow. Radio frequency and envelope signals were used to calculate the decorrelation pattern. The results were compared to the mean decorrelation pattern for plug blood-flow. The RF signals decorrelation patterns were in good agreement with those obtained for plug blood flow. Envelope decorrelation patterns show a close agreement with the one for plug blood flow. For axial blood flow, there is a discrepancy between decorrelation patterns. The results presented here suggest that the decorrelation properties of an IVUS array catheter for measuring quantitative transverse blood flow probably will not be affected by different transverse blood-flow conditions.

Blood Flow Velocity↗