Vector Flow Imaging Compared with Digital Subtraction Angiography for Stenosis Assessment in the Superficial Femoral Artery – A Study of Vector Concentration, Velocity Ratio and Stenosis Degree Percentage

Kristoffer Lindskov Hansen; Peter Møller Hansen; Caroline Ewertsen; Lars Lönn; Jørgen Arendt Jensen; Michael Bachmann Nielsen

doi:10.1055/a-0853-2002

Ultrasound International Open, Table of Contents

CC BY-NC-ND 4.0 · Ultrasound Int Open 2019; 05(02): E53-E59
DOI: 10.1055/a-0853-2002

Original Article

Vector Flow Imaging Compared with Digital Subtraction Angiography for Stenosis Assessment in the Superficial Femoral Artery – A Study of Vector Concentration, Velocity Ratio and Stenosis Degree Percentage

Kristoffer Lindskov Hansen

¹Department of Diagnostic Radiology, Copenhagen University Hospital, Copenhagen, Denmark

²Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

,

Peter Møller Hansen

¹Department of Diagnostic Radiology, Copenhagen University Hospital, Copenhagen, Denmark

,

Caroline Ewertsen

¹Department of Diagnostic Radiology, Copenhagen University Hospital, Copenhagen, Denmark

²Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

,

Lars Lönn

¹Department of Diagnostic Radiology, Copenhagen University Hospital, Copenhagen, Denmark

³Department of Vascular Surgery, Copenhagen University Hospital, Copenhagen, Denmark

,

Jørgen Arendt Jensen

⁴Center for Fast Ultrasound Imaging, Technical University of Denmark, DTU Elektro, Kgs. Lyngby, Denmark

,

Michael Bachmann Nielsen

¹Department of Diagnostic Radiology, Copenhagen University Hospital, Copenhagen, Denmark

²Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

› Author Affiliations

Abstract

Purpose

Stenosis of the superficial femoral artery (SFA) induces complex blood flow with increased velocities. Disease assessment is performed with Doppler ultrasound and digital subtraction angiography (DSA), but Doppler ultrasound is limited by angle dependency and DSA by ionizing radiation. An alternative is the vector flow imaging method based on transverse oscillation (TO), an angle-independent vector velocity technique using ultrasound. In this study, flow complexity and velocity measured with TO were compared with DSA for the assessment of stenosis in the SFA.

Materials and Methods

The vector concentration, a measure of flow complexity, and the velocity ratio obtained from the stenosis and a disease-free adjacent vessel segment, were estimated with TO in 11 patients with a total of 16 stenoses of the SFA. TO data were compared with the corresponding stenosis degree percentage obtained with DSA.

Results

The correlation between the vector concentration and DSA was very strong (R=0.93; p<0.001; 95% confidence interval (CI): 0.81–0.98), while only moderate for velocity ratio and DSA (R=0.50; p<0.07; 95% CI: 0.00–0.80). The correlation coefficients that were found were significantly different (p<0.005) without overlapping CI.

Conclusion

The study indicated that flow changes in the SFA induced by stenosis can be quantified with TO, and that stenosis grading may be improved by estimation of flow complexity instead of velocity ratio. TO is a potential diagnostic tool for the assessment of atherosclerosis and peripheral arterial disease.

Key words

vector flow imaging - vector concentration - velocity ratio - digital subtraction angiography - peripheral arterial disease

Full Text

References

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