US Velocimetry in Participants with Aortoiliac Occlusive Disease

doi: 10.4121/c.5497704.v2
The doi above is for this specific version of this collection, which is currently the latest. Newer versions may be published in the future. For a link that will always point to the latest version, please use
doi: 10.4121/c.5497704
Datacite citation style:
Stefan Engelhard; Versluis, Michel; Groot Jebbink, Erik; Reijnen, Michel M. P. J.; van Helvert, Majorie (2021): US Velocimetry in Participants with Aortoiliac Occlusive Disease. Version 2. 4TU.ResearchData. collection.
Other citation styles (APA, Harvard, MLA, Vancouver, Chicago, IEEE) available at Datacite
choose version:
version 2 - 2021-12-08 (latest)
version 1 - 2021-10-26
Background: The accurate quantification of blood flow in aortoiliac arteries is challenging but clinically relevant because local flow patterns can influence atherosclerotic disease.
Purpose: To investigate the feasibility and clinical application of two-dimensional blood flow quantification using high-frame-rate contrast-enhanced US (HFR-CEUS) and particle image velocimetry (PIV), or US velocimetry, in participants with aortoiliac stenosis.
Materials and Methods: In this prospective study, participants with a recently diagnosed aortoiliac stenosis underwent HFR-CEUS measurements of the pre- and poststenotic vessel segments (August 2018 to July 2019). Two-dimensional quantification of blood flow was achieved by performing PIV analysis, which was based on pairwise cross-correlation of the HFR-CEUS images. Visual inspection of the entire data set was performed by five observers to evaluate the ability of the technique to enable adequate visualization of blood flow. The contrast-to-background ratio and average vector correlation were calculated. In two participants who showed flow disturbances, the flow complexity and vorticity were calculated.
Results: Thirty-five participants (median age, 67 years; age range, 56–84 years; 22 men) were included. Visual scoring showed that flow quantification was achieved in 41 of 42 locations. In 25 locations, one or multiple issues occurred that limited optimal flow quantification, including loss of correlation during systole (n = 12), shadow regions (n = 8), a short vessel segment in the image plane (n = 7), and loss of contrast during diastole (n = 5). In the remaining 16 locations, optimal quantification was achieved. The contrast-to-background ratio was higher during systole than during diastole (11.0 6 2.9 vs 6.9 6 3.4, respectively; P , .001), whereas the vector correlation was lower (0.58 6 0.21 vs 0.47 6 0.13; P , .001). The flow complexity and vorticity were high in regions with disturbed flow.
Conclusion: Blood flow quantification with US velocimetry is feasible in patients with an aortoiliac stenosis, but several challenges must be overcome before implementation into clinical practice.
  • 2021-10-26 first online
  • 2021-12-08 published, posted, revised
  • Stichting Lijf en Leven
University of Twente, Multi-Modality Medical Imaging Group, TechMed Centre
Rijnstate hospital, Department of Vascular Surgery
University of Twente, Physics of Fluids Group, TechMed Centre
Erasmus Medical Center, Department of Biomedical Engineering, Thorax Center