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Combined B-Mode and Multigate Spectral Doppler-Mode Imaging for Flow-Mediated Dilation Investigation

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Acoustical Imaging

Part of the book series: Acoustical Imaging ((ACIM,volume 31))

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Abstract

Flow-mediated dilation (FMD) is an established non-invasive method to assess the endothelial function by ultrasound. Blood flow in the brachial artery is restricted by a cuff for about 5 min: during the reactive hyperemia following occlusion release, the consequent increase in wall shear stress stimulates the endothelial cells to release nitric oxide, a powerful vasodilator that causes relaxation of tunica media smooth muscle. By measuring the arterial diameter change induced by reactive hyperemia, a possible endothelial dysfunction can be detected. The traditional approach consists in the evaluation of arterial diameter changes, while the shear stress increase (i.e. the stimulus for dilation) has not been directly estimated so far. This paper describes an approach to simultaneously measure the wall shear rate (WSR), i.e. the blood velocity gradient near the walls, and the associated diameter changes. The WSR is measured through multigate spectral Doppler (MSD) analysis while B-Mode images are processed to estimate the instantaneous diameter. This approach was implemented in the ULtrasound Advanced Open Platform (ULA-OP), which can be programmed to arbitrarily interleave B- and PW Doppler- Modes. The method implementation and the results of a clinical validation over 15 healthy volunteers are reported.

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Acknowledgments

The authors wish to acknowledge the technical contribution of all MSD Lab staff, and in particular A. Dallai.

 The research was supported by the European Union’s Seventh Framework Programme (FP7/2007–2013) for the Innovative Medicine Initiative under grant agreement n° IMI/115006 (the SUMMIT consortium).

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Authors and Affiliations

  1. Electronics and Telecommunications, University of Florence, Florence, Italy

    Lorenzo Francalanci, Luca Bassi & Piero Tortoli

  2. Section of Anesthesiology, Department of Surgery, University of Pisa, Pisa, Italy

    Carlo Palombo

  3. Department of Internal Medicine, University of Pisa, Pisa, Italy

    Lorenzo Ghiadoni & Giacomo Bini

Authors
  1. Lorenzo Francalanci
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  2. Carlo Palombo
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  3. Lorenzo Ghiadoni
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  4. Giacomo Bini
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  5. Luca Bassi
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  6. Piero Tortoli
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Corresponding author

Correspondence to Piero Tortoli .

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Editors and Affiliations

  1. Polish Academy of Sciences, IPPT, Pawinskiego 5 b, Warszawa, 02-106, Poland

    Andrzej Nowicki

  2. , Inst. Fundamental Technological Research, Polish Academy of Sciences, IPPT, Pawinskiego 5 b, Warszawa, 02-106, Poland

    Jerzy Litniewski

  3. Polish Academy of Sciences, IPPT, Pawinskiego 5 b, Warszawa, 02-106, Poland

    Tamara Kujawska

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Francalanci, L., Palombo, C., Ghiadoni, L., Bini, G., Bassi, L., Tortoli, P. (2012). Combined B-Mode and Multigate Spectral Doppler-Mode Imaging for Flow-Mediated Dilation Investigation. In: Nowicki, A., Litniewski, J., Kujawska, T. (eds) Acoustical Imaging. Acoustical Imaging, vol 31. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2619-2_8

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  • DOI: https://doi.org/10.1007/978-94-007-2619-2_8

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  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-2618-5

  • Online ISBN: 978-94-007-2619-2

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