2023 journal article

Estimating Thrombus Elasticity by Shear Wave Elastography to Evaluate Ultrasound Thrombolysis for Thrombus With Different Stiffness


By: A. Rayes*, J. Zhang*, G. Lu*, X. Qian*, S. Schroff*, R. Ryu*, X. Jiang n, Q. Zhou*

co-author countries: Saudi Arabia 🇸🇦 United States of America 🇺🇸
author keywords: Elasticity; Vibrations; Transducers; inertial cavitation; shear wave elastography; shear wave speed; thrombus; thrombolysis; ultrasound
MeSH headings : Humans; Elasticity Imaging Techniques / methods; Ultrasonography / methods; Elasticity; Thrombosis / diagnostic imaging; Thrombosis / drug therapy; Thrombolytic Therapy
Source: Web Of Science
Added: March 20, 2023

<italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Objective</i> : There is uncertainty about deep vein thrombosis standard treatment as thrombus stiffness alters each case. Here, we investigated thrombus’ stiffness of different compositions and ages using shear wave elastography (SWE). We then studied the effectiveness of ultrasound-thrombolysis on different thrombus compositions. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Methods</i> : Shear waves generated through mechanical shaker and traveled along thrombus of different hematocrit (HCT) levels, whereas 18-MHz ultrasound array used to detect wave propagation. Thrombus’ stiffness was identified by the shear wave speed (SWS). In thrombolysis, a 3.2 MHz focused transducer was applied to different thrombus compositions using different powers. The thrombolysis rate was defined as the percentage of weight loss. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Results</i> : The estimated average SWS of 20%, 40%, and 60% HCT thrombus were 0.75 m/s, 0.44 m/s, and 0.32 m/s, respectively. For Thrombolysis, the percentage weight loss at 8 MPa Negative pressure for the same HCT groups were 23.1%, 35.29%, and 39.66% respectively. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Conclusion:</i> SWS is inversely related to HCT level and positively related to thrombus age. High HCT thrombus had higher weight loss compared to low HCT. However, the difference between 20% and 40% HCT was more significant than between 40% and 60% HCT in both studies. Our results suggest that thrombus with higher SWS require more power to achieve the same thrombolysis rate as thrombus with lower SWS. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Significance:</i> Characterizing thrombus elastic property undergoing thrombolysis enables evaluation of ultrasound efficacy for fractionating thrombus and reveals the appropriate ultrasound parameters selection to achieve a certain thrombolysis rate in the case of a specific thrombus stiffness.