Biomedical subjects

Stanislav Y Emelianov

Publications and source records attributed to Stanislav Y Emelianov.

13 recordsLinked to original sources

PubMed2006

Sonographic elasticity imaging of acute and chronic deep venous thrombosis in humans.

OBJECTIVE: The purpose of this study was to assess the ability of sonographic elasticity imaging to distinguish acute from chronic deep venous thrombosis (DVT). METHODS: Fifty-four patients, 26 with acute DVT and 28 with chronic DVT, were studied, and we analyzed the data in 46 patients, 23 with acute (mean age, 5.7 days) and 23 with chronic (>8 months) DVT. Scanning was performed with a 5-MHz linear array transducer during continuous freehand external deformation of each thrombus using the ultrasound scan head. The strains in the thrombi were normalized to the average strain between the skin surface and the back wall of the vein. Relative thrombus echogenicity was measured by comparing the echogenicity of the thrombus with that of the adjacent arterial lumen. Statistical analyses were performed with the Mann-Whitney U test and receiver operating characteristic analysis. RESULTS: The median normalized strain magnitude for the acute cases was 2.75, with an interquartile range of 2.4 to 3.71, whereas the median normalized strain magnitude for the chronic cases was 0.94, with interquartile range of 0.48 to 1.36. The difference was highly significant (P < 10(-7)). The area under the receiver operating characteristic curve (A(z)) was 0.97 +/- 0.02 (SE). The echogenicity difference between the populations was highly significant (P < 10(-5)), with A(z) of 0.92 +/- 0.04. The difference between the A(z) values was not significant (P > .05). CONCLUSIONS: In this population, sonographic elasticity imaging performs at least as well as thrombus echogenicity. Thrombus aging using elasticity imaging would be particularly helpful in evaluating symptoms in patients with post-thrombotic syndrome.

Acute Disease↗

PubMed2005

Correspondence of ultrasound elasticity imaging to direct mechanical measurement in aging DVT in rats.

Previous ultrasound elasticity imaging experiments supported a generally accepted concept that the hardness of deep venous thrombi increases with thrombus aging. Results also showed that this noninvasive imaging technique can accurately predict thrombus age through strain estimates, in a well-controlled animal study. In the present study, as an alternative means to characterize elastic properties of thrombi, we used a direct mechanical measurement system to estimate Young's modulus of ex vivo thrombi. Unlike conventional indentation tests, the device uses a specific compression geometry for cylindrical tissue specimens. We also proposed an approximation scheme to retrieve Young's modulus from force-displacement measurements made using the device. Finite element simulations and calibrations on tissue-mimicking phantoms validated the system. Then, using two groups of rats with surgically-induced thrombi, we further investigated the correlation between Young's modulus measured ex vivo and elasticity images reconstructed in vivo. This comparison was accomplished by converting the intrathrombus strains measured in the in vivo studies into Young's modulus estimates using a model-based approach. Good agreement between time-dependent Young's modulus estimates observed in vivo and direct measurements of Young's modulus using the mechanical device helps to confirm the ability of elasticity imaging to age deep venous thrombi for efficient treatment.

Aging↗

PubMed2005

Gas bubble and solid sphere motion in elastic media in response to acoustic radiation force.

The general approach to estimate the displacement of rounded objects (specifically, gas bubbles and solid spheres) in elastic incompressible media in response to applied acoustic radiation force is presented. In this study, both static displacement and transient motion are analyzed using the linear approximation. To evaluate the static displacement of the spherical inclusion, equations coupling the applied force, displacement, and shear modulus of the elastic medium are derived. Analytical expressions to estimate the static displacement of solid spheres and gas bubbles are presented. Under a continuously applied static force, both the solid sphere and the initially spherical gas bubble are displaced, and the bubble is deformed. The transient responses of the inclusions are described using motion equations. The displacements of the inclusion in elastic incompressible lossless media are analyzed using both frequency-domain and time-domain formalism, and the equations of motion are derived for both a solid sphere and a gas bubble. For a short pulsed force, an analytical solution for the equations of motion is presented. Finally, transient displacement of the gas bubble in viscoelastic media is considered.

Acoustics↗

PubMed2004

Staging deep venous thrombosis using ultrasound elasticity imaging: animal model.

Deep venous thrombi undergo progressive hardening with age. However, the evolution rate remains poorly characterized by both invasive and noninvasive techniques. In a previous study (Emelianov et al. 2002), we demonstrated the potential of ultrasound elasticity imaging to noninvasively detect and age thrombus using a rat-based model. Knowing that thrombi harden over time is useful, but the value of the technique relies on whether the age of a thrombus can be predicted from strain estimates, and how accurate these predictions are. The objective of the present study is to answer these two questions. In the previous study, thrombus elasticity changes were monitored only on day 3, 6 and 9 after surgically induced formation of thrombosis in rat inferior vena cavas. In this study, ultrasound elasticity imaging was performed on two independent groups of rats (16 in total) starting from day 3 through day 10 with more temporal samples through the thrombus maturation process. For each rat, thrombus hardness was quantified at each scan interval by measures of normalized strains and reconstructed relative Young's moduli. In both groups, strain magnitudes exhibit progressive decrease as clots age. The relationship between the normalized strain and the clot age was developed from the first group and evaluated by the second group. Statistical analysis showed that the age estimation accuracy is within 0.8 day. If further research can successfully transfer the animal clot-hardening model to human patients, we believe that elasticity imaging will become a key component of venous compression ultrasound for effective diagnosis and treatment of deep venous thrombosis.

Animals↗

PubMed2004

Measuring the nonlinear elastic properties of tissue-like phantoms.

A direct mechanical system simultaneously measuring external force and deformation of samples over a wide dynamic range is used to obtain force-displacement curves of tissue-like phantoms under plain strain deformation. These measurements, covering a wide deformation range, then are used to characterize the nonlinear elastic properties of the phantom materials. The model assumes incompressible media, in which several strain energy potentials are considered. Finite-element analysis is used to evaluate the performance of this material characterization procedure. The procedures developed allow calibration of nonlinear elastic phantoms for elasticity imaging experiments and finite-element simulations.

Adult↗

PubMed2004

Feasibility of applying ultrasound strain imaging to detect renal transplant chronic allograft nephropathy.

Chronic renal transplantation fibrosis, often termed Chronic Allograft Nephropathy, may progress undetected. Since renal fibrosis may be accompanied by a change in measurable elastic tissue properties, ultrasound strain management may be useful in it detection. Ultrasound strain imaging was performed for two subjects with renal transplants; one with normal renal function and one with mild renal insufficiency and biopsy demonstrated fibrosis. Subjects underwent ultrasound examination with application of a controlled deformation using phase-sensitive, two-dimensional speckle tracking to evaluate internal tissue motion to measure tissue displacement and strain. Measurements over multiple beams for an equivalent deformational stress showed there was a threefold difference in renal cortical strain between the two subjects. These data suggest that ultrasound elasticity imaging may prove useful in measuring mechanical changes related to fibrosis with the transplant kidney.

Adult↗

PubMed2004

Nonlinear dynamics of a gas bubble in an incompressible elastic medium.

A nonlinear model in the form of the Rayleigh-Plesset equation is developed for a gas bubble in an essentially incompressible elastic medium such as a tissue or rubberlike medium. Two constitutive laws for the elastic medium are considered: the Mooney potential, and Landau's expansion of the strain energy density. These two constitutive laws are compared at quadratic order to obtain a relation between their respective elastic constants. Attention is devoted to the relative importance of shear stress on the bubble dynamics, allowing for the equilibrium gas pressure in the bubble to differ substantially from the pressure at infinity. The model for the bubble motion is approximated to quadratic order to assess the importance of shear stress in the surrounding medium relative to that of the gas pressure in the bubble. Relations are derived for the value of the shear wave speed at which the two contributions are comparable, which provide an assessment of when shear stress in the surrounding medium must be taken into account when modeling bubble dynamics.

Journal Article↗

PubMed2004

Model-based reconstructive elasticity imaging of deep venous thrombosis.

Deep venous thrombosis (DVT) and its sequela, pulmonary embolism, is a significant clinical problem. Once detected, DVT treatment is based on the age of the clot. There are no good noninvasive methods, however, to determine clot age. Previously, we demonstrated that imaging internal mechanical strains can identify and possibly age thrombus in a deep vein. In this study the deformation geometry for DVT elasticity imaging and its effect on Young's modulus estimates is addressed. A model-based reconstruction method is presented to estimate elasticity in which the clot-containing vessel is modeled as a layered cylinder. Compared to an unconstrained approach in reconstructive elasticity imaging, the proposed model-based approach has several advantages: only one component of the strain tensor is used; the minimization procedure is very fast; the method is highly efficient because an analytic solution of the forward elastic problem is used; and the method is not very sensitive to the details of the external load pattern--a characteristic that is important for free-hand, external, surface-applied deformation. The approach was tested theoretically using a numerical model, and experimentally on both tissue-like phantoms and an animal model of DVT. Results suggest that elasticity reconstruction may prove to be a practical adjunct to triplex scanning to detect, diagnose, and stage DVT.

Aging↗

PubMed2004

Nonlinear elasticity imaging: theory and phantom study.

In tissue the Young's modulus cannot be assumed constant over a wide deformation range. For example, direct mechanical measurements on human prostate show up to a threefold increase in Young's modulus over a 10% deformation. In conventional elasticity imaging, these effects produce strain-dependent elastic contrast. Ignoring these effects generally leads to suboptimal contrast (stiffer tissues at lower strain are contrasted against softer tissues at higher strain), but measuring the nonlinear behavior results in enhanced tissue differentiation. To demonstrate the methods extracting nonlinear elastic properties, both simulations and measurements were performed on an agar-gelatin phantom. Multiple frames of phase-sensitive ultrasound data are acquired as the phantom is deformed by 12%. All interframe displacement data are brought back to the geometry of the first frame to form a three-dimensional (3-D) data set (depth, lateral, and preload dimensions). Data are fit to a 3-D second order polynomial model for each pixel that adjusts for deformation irregularities. For the phantom geometry and elastic properties considered in this paper, reconstructed frame-to-frame strain images using this model result in improved contrast to noise ratios (CNR) at all preload levels, without any sacrifice in spatial resolution. From the same model, strain hardening at all preload levels can be extracted. This is an independent contrast mechanism. Its maximum CNR occurs at 5.13% preload, and it is a 54% improvement over the best case (preload 10.6%) CNR for frame-to-frame strain reconstruction. Actual phantom measurements confirm the essential features of the simulation. Results show that modeling of the nonlinear elastic behavior has the potential to both increase detectability in elasticity imaging and provide a new independent mechanism for tissue differentiation.

Algorithms↗

PubMed2004

Lateral speckle tracking using synthetic lateral phase.

In traditional speckle tracking, lateral displacement (perpendicular to the beam direction) estimates are much less accurate than axial ones (along the beam direction). The accuracy of lateral tracking is very important whenever spatial derivatives of both axial and lateral displacements are required to give a full description of a two-dimensional (2-D) strain field. A number of methods have been proposed to improve lateral tracking by increasing the sampling rate in the lateral direction. We propose an alternate method using synthetic lateral phase (SLP). The algorithm, a direct analog of the phase zero-crossing approach used in axial displacement estimation, synthesizes the lateral phase first, then performs a zero-crossing detection on this synthetic phase to obtain lateral displacement estimates. The SLP is available by simply eliminating either the positive or negative half of the lateral spectrum of the original analytic signal. No new data need to be acquired for this procedure. This new algorithm was tested on both simulations and measurements from a cardiac phantom model. Results show that the method greatly improves the accuracy of lateral tracking, especially for low strain cases (< or =1%). The standard deviation of the estimation error of the lateral normal strain obtained with this approach has an approximate factor of 2-3 improvement for low strain cases. The conceptual and computational simplicity of this new method makes it a practical approach to improve lateral tracking for elasticity imaging.

Algorithms↗

PubMed2003

Clinical application of sonographic elasticity imaging for aging of deep venous thrombosis: preliminary findings.

OBJECTIVE: Aging of deep venous thrombosis is an important and difficult clinical problem. Because it is known that thrombi harden as they mature, we have preliminarily tested sonographic elasticity imaging, a technique that estimates tissue hardness, to age venous thrombi. METHODS: Two adult patients with lower extremity thrombi were studied. One had a clinically chronic thrombus (at least 3 years old), whereas the other patient's thrombus was clinically subacute (25 days old). We performed freehand compression sonographic scans using a 5-MHz linear array transducer. Phase-sensitive B-scan frames were processed offline by a two-dimensional complex correlation-based adaptive speckle-tracking technique. The distribution of internal strains in the wall of the vein, thrombus, and surrounding tissue was analyzed. Clot hardness was normalized to the venous wall. RESULTS: The chronic clot was homogeneous, and the strain in the chronic clot was at least 10 times smaller than that in the vessel wall. The subacute clot was much more heterogeneous, and, on average, the strain magnitude in the clot was 3 to 4 times greater than that in the vessel wall. CONCLUSIONS: In this preliminary work, the 2 thrombi appeared very different, and these results suggest that elasticity imaging may be able to age deep venous thrombosis.

Adult↗

PubMed2002

Strain imaging of corneal tissue with an ultrasound elasticity microscope.

PURPOSE: We hypothesize that high-resolution elasticity measurements can guide corrective refractive surgery of the cornea. Elasticity measurements would improve surgical outcomes by adding biomechanical information not used in existing clinical nomograms. As an initial investigation, we determined the usefulness and evaluated the ability of our ultrasound elasticity microscope by measuring strain ex vivo in an intact porcine eye globe. METHODS: Strain was predicted with a finite element model guided by direct mechanical measurements of corneal elasticity. Next, a porcine cornea was deformed with a slitted plate while being imaged with ultrasound. For high spatial resolution, the ultrasound elasticity microscope uses a 50 MHz transducer with a 1.4 f/number. It produces high-quality conventional ultrasonic B-scans over large thicknesses by confocal processing. Strain was calculated from tracking speckle in these images after deformation. This technique is compatible with in vivo measurements. RESULTS: Compressional and expansional deformations were the same order of magnitude from -3.5% to as great as +3.5%. Strain imaging indicated the stroma expanded into the slit of the deformation plate while Bowman's layer compressed. This bipolar variation within a specimen is unusual. Within the stroma, a variation of strain with depth was measured suggesting a distribution of elasticity. Results compared favorably with the finite element model. CONCLUSION: An ultrasound elasticity microscope can produce high-resolution strain images throughout the corneal depth. Various layers with different elastic properties appeared as different strains in the images.

Animals↗

PubMed2002

An integrated compliant balloon ultrasound catheter for intravascular strain imaging.

An integrated compliant balloon ultrasound catheter was developed to allow greater deformations in strain imaging with intravascular ultrasound. A 64-element circumferential array was placed inside a compliant silicone balloon catheter to capture real-time, phase-sensitive radio frequency (RF) data during deformation experiments. Strains over 40% could be applied to normal arterial wall tissue with intracatheter pressures as low as 200 kPa (2 atm). Strain images of a hard-soft rubber phantom, thrombus, and fibrotic plaque were produced using the integrated balloon ultrasound catheter. Results show that this catheter can apply large deformations at low pressures and image various vascular pathologies ex vivo. Potentially, it can serve as a multifunctional, intravascular therapeutic device to guide angioplasty and stent deployment.

Animals↗