| 研究生: |
湯杰儒 Tang, Chieh-Ju |
|---|---|
| 論文名稱: |
新型超音波技術用於量測人類頸動脈局部脈波傳遞速度 A novel ultrasound approach for measuring the local pulse wave velocity of human carotid artery |
| 指導教授: |
黃執中
Huang, Chih-Chung |
| 學位類別: |
碩士 Master |
| 系所名稱: |
工學院 - 生物醫學工程學系 Department of BioMedical Engineering |
| 論文出版年: | 2019 |
| 畢業學年度: | 107 |
| 語文別: | 英文 |
| 論文頁數: | 63 |
| 中文關鍵詞: | 心血管疾病 、動脈硬化 、超音波 、局部脈波速度 、頸股動脈脈波速度 |
| 外文關鍵詞: | Cardiovascular disease, Arterial stiffness, Ultrasound, Local PWV, Carotid-Femoral PWV |
| 相關次數: | 點閱:119 下載:3 |
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迄今為止,心血管疾病一直為造成全球人口死亡的主要疾病。因此人們對於早期預防心血管疾病非常重視。在過去研究中,頸動脈 - 股動脈脈波速度已被廣泛認為是評估心血管疾病的可靠臨床參數,但此量測方法上仍有一些問題會導致量測結果有誤差。而最近有許多基於超音波成像技術來量測局部脈搏波速度已被提出,局部脈波速度可以提供更多的臨床資訊並且可作為早期診斷心血管疾病的一種工具。然而超音波成像技術上需要高解析度的影像來呈現局部脈波速度相關資訊,因此會有較複雜的運算。
在本論文中透過線性陣列換能器激發少量超音波陣元取得血管壁的訊號,採用訊號峰值收尋的方法估計血管壁的運動,並以已知陣元距離與管壁位移波形傳遞的時間之線性關係估計局部脈波速度。而該方法僅提供局部脈波速度之平均數值,以利於大量人口檢測。此方法之可靠性已在本論文中被討論,透過自製血管仿體進行體外實驗。實驗結果中發現僅透過8個超音波波束進行量測,也可以準確估計局部脈波速度。另外在薄與厚的仿體上發現該方法估計之脈波速度與Moens-Korteweg 公式推測之血管仿體理論脈波速度間有良好的一致性。
此外,在健康年輕受試者中透過提出方法估計之頸動脈脈波速度與商業儀器SphygmoCor量測之頸動脈 - 股動脈脈波速度之關係也在本論文中被討論。實驗結果顯示, 頸股動脈平均脈波速度與頸動脈平均脈波速度分別為6.82±0.49 m/s 與 4.72±0.50 m/s,且兩者間存在良好的線性相關性(r=0.82)。這些結果與先前的研究結果一致。
在本論文中,基於超音波提出了一種低運算成本、非侵入性用於測量局部脈搏波速度之方法並且確認頸股動脈脈波速度與頸動脈脈波速度的相關性。
About the major cause of the death globally has been attributed to cardiovascular diseases (CVDs) until now,such issue has drawn attention to the importance of CVDs for the early prevention. In the past studies, the Carotid–femoral pulse wave velocity (cfPWV) has been widely considered to be a reliable clinical parameter for evaluate of the CVDs risk. But this method still has some significant limitations which results into errors for cfPWV measurements. Recently, several ultrasound imaging-based methods have been proposed to measure the local PWV, that can exhibit more clinical significance and can be used as an early diagnosis tool. However, ultrasonic imaging technology requires high-resolution images to present local PWV related information, it’s usually along with complicated operations.
In this study, use a linear array transducer to excite a limited element for obtaining the signal of the vessel wall, and the wall motion estimated by the peak finding method. The local PWV was measured by the relationship between known element’s locations and pulse wave travel time. The proposed method only provides the average value of the local PWV to facilitate large population detection. The reliability of proposed method has been discussed via the in vitro experiments which performed by self-made vessel phantoms. The experimental results show that the measurement of 8 transducer beams also can be used to accurately estimate the local PWV. And the good agreement was found between reference PWVs and local PWVs on thin and thick phantoms obtained from Moens-Korteweg equation and proposed method.
On the other hand, the relationship between cfPWV and carotid PWV in young healthy subjects was also discussed in this study which obtained from SphygmoCor device and proposed method. The measured PWVs in vivo are 6.82±0.49 m/s and 4.72±0.50 m/s for cfPWV and local PWV, respectively. A good linear correlation was found between cfPWV and local PWV (r=0.82) which agree with previous study.
In this study, the low computing cost and noninvasive method based on ultrasound was proposed for measuring the local PWV and comparing the correlation between cfPWV and carotid PWV in human.
[1] A. Alwan, Global status report on noncommunicable diseases 2010. World Health Organization, 2011.
[2] A. P. Avolio, "Multi-branched model of the human arterial system," Med Biol Eng Comput, vol. 18, no. 6, pp. 709-18, Nov 1980.
[3] H. A. McAllister, Jr., "An overview of human arterial pathology," Toxicol Pathol, vol. 17, no. 1 Pt 2, pp. 219-31, 1989.
[4] C. Kleinstreuer, Z. Li, and M. Farber, "Fluid-structure interaction analyses of stented abdominal aortic aneurysms," Annu. Rev. Biomed. Eng., vol. 9, pp. 169-204, 2007.
[5] T. O. Aje and M. Miller, "Cardiovascular disease: a global problem extending into the developing world," World journal of cardiology, vol. 1, no. 1, p. 3, 2009.
[6] W. H. Organization, "Cardiovascular diseases (CVDs)."
[7] C. D. Mathers and D. Loncar, "Projections of global mortality and burden of disease from 2002 to 2030," PLoS medicine, vol. 3, no. 11, p. e442, 2006.
[8] J. N. Cohn, "Arterial stiffness, vascular disease, and risk of cardiovascular events," ed: Am Heart Assoc, 2006.
[9] R. Ross, "The pathogenesis of atherosclerosis: a perspective for the 1990s," Nature, vol. 362, no. 6423, p. 801, 1993.
[10] J. N. Cohn et al., "Noninvasive pulse wave analysis for the early detection of vascular disease," Hypertension, vol. 26, no. 3, pp. 503-508, 1995.
[11] G. A. Lammie, P. A. Sandercock, and M. S. Dennis, "Recently occluded intracranial and extracranial carotid arteries: relevance of the unstable atherosclerotic plaque," Stroke, vol. 30, no. 7, pp. 1319-1325, 1999.
[12] M. J. Davies and A. C. Thomas, "Plaque fissuring--the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina," British heart journal, vol. 53, no. 4, p. 363, 1985.
[13] J. J. Oliver and D. J. Webb, "Noninvasive assessment of arterial stiffness and risk of atherosclerotic events," Arteriosclerosis, thrombosis, and vascular biology, vol. 23, no. 4, pp. 554-566, 2003.
[14] F. U. Mattace-Raso et al., "Arterial stiffness and risk of coronary heart disease and stroke," Circulation, vol. 113, no. 5, pp. 657-663, 2006.
[15] J. E. Wagenseil and R. P. Mecham, "Elastin in large artery stiffness and hypertension," J Cardiovasc Transl Res, vol. 5, no. 3, pp. 264-73, Jun 2012.
[16] D. Beattie, C. Xu, R. Vito, S. Glagov, and M. Whang, "Mechanical analysis of heterogeneous, atherosclerotic human aorta," Journal of biomechanical engineering, vol. 120, no. 5, pp. 602-607, 1998.
[17] S. J. Zieman, V. Melenovsky, and D. A. Kass, "Mechanisms, pathophysiology, and therapy of arterial stiffness," Arteriosclerosis, thrombosis, and vascular biology, vol. 25, no. 5, pp. 932-943, 2005.
[18] V. Markussis, S. A. Beshyah, C. Fisher, K. H. Parker, A. N. Nicolaides, and D. G. Johnston, "Abnormal carotid arterial wall dynamics in symptom-free hypopituitary adults," European journal of endocrinology, vol. 136, no. 2, pp. 157-164, 1997.
[19] A. I Christen et al., "Arterial wall structure and dynamics in type 2 diabetes mellitus methodological aspects and pathophysiological findings," Current diabetes reviews, vol. 6, no. 6, pp. 367-377, 2010.
[20] T. Buchner, J. Pietkun, and P. Kuklik, "Complex activity patterns in arterial wall: Results from a model of calcium dynamics," Computers in biology and medicine, vol. 42, no. 3, pp. 267-275, 2012.
[21] G. Mancia et al., "2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)," Blood pressure, vol. 22, no. 4, pp. 193-278, 2013.
[22] W. R. Milnor, "Hemodynamics," Cardiac dynamics, 1989.
[23] C. Stefanadis et al., "Pressure-diameter relation of the human aorta: a new method of determination by the application of a special ultrasonic dimension catheter," Circulation, vol. 92, no. 8, pp. 2210-2219, 1995.
[24] R. Asmar et al., "Assessment of arterial distensibility by automatic pulse wave velocity measurement: validation and clinical application studies," Hypertension, vol. 26, no. 3, pp. 485-490, 1995.
[25] K. Hirata, M. Kawakami, and M. F. O'Rourke, "Pulse wave analysis and pulse wave velocity," Circulation journal, vol. 70, no. 10, pp. 1231-1239, 2006.
[26] T. Willum-Hansen et al., "Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population," Circulation, vol. 113, no. 5, pp. 664-70, Feb 7 2006.
[27] Y. Ben-Shlomo et al., "Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects," Journal of the American College of Cardiology, vol. 63, no. 7, pp. 636-646, 2014.
[28] M. F. O'Rourke and W. Nichols, McDonald's blood flow in arteries: theoretical, experimental and clinical principles. Hodder Arnold London, 2005.
[29] T. Pereira, C. Correia, and J. Cardoso, "Novel Methods for Pulse Wave Velocity Measurement," J Med Biol Eng, vol. 35, no. 5, pp. 555-565, 2015.
[30] S. Laurent et al., "Expert consensus document on arterial stiffness: methodological issues and clinical applications," European heart journal, vol. 27, no. 21, pp. 2588-2605, 2006.
[31] J. Blacher, R. Asmar, S. Djane, G. M. London, and M. E. Safar, "Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients," Hypertension, vol. 33, no. 5, pp. 1111-1117, 1999.
[32] M. W. Rajzer, W. Wojciechowska, M. Klocek, I. Palka, M. Brzozowska-Kiszka, and K. Kawecka-Jaszcz, "Comparison of aortic pulse wave velocity measured by three techniques: Complior, SphygmoCor and Arteriograph," Journal of hypertension, vol. 26, no. 10, pp. 2001-2007, 2008.
[33] R. Williams et al., "Noninvasive ultrasonic measurement of regional and local pulse-wave velocity in mice," Ultrasound Med Biol, vol. 33, no. 9, pp. 1368-75, Sep 2007.
[34] M. A. Darwich, F. Langevin, and K. Darwich, "Local pulse wave velocity estimation in the carotids using dynamic MR sequences," Journal of Biomedical Science and Engineering, vol. 8, no. 04, p. 227, 2015.
[35] A. Harada, T. Okada, K. Niki, D. Chang, and M. Sugawara, "On-line noninvasive one-point measurements of pulse wave velocity," Heart and vessels, vol. 17, no. 2, pp. 61-68, 2002.
[36] S. I. Rabben et al., "An ultrasound-based method for determining pulse wave velocity in superficial arteries," Journal of biomechanics, vol. 37, no. 10, pp. 1615-1622, 2004.
[37] A. Swillens, L. Taelman, J. Degroote, J. Vierendeels, and P. Segers, "Comparison of non-invasive methods for measurement of local pulse wave velocity using FSI-simulations and in vivo data," Annals of biomedical engineering, vol. 41, no. 7, pp. 1567-1578, 2013.
[38] M. Benthin, P. Dahl, R. Ruzicka, and K. Lindström, "Calculation of pulse-wave velocity using cross correlation—effects of reflexes in the arterial tree," Ultrasound in medicine & biology, vol. 17, no. 5, pp. 461-469, 1991.
[39] P. J. Brands, J. M. Willigers, L. A. Ledoux, R. S. Reneman, and A. P. Hoeks, "A noninvasive method to estimate pulse wave velocity in arteries locally by means of ultrasound," Ultrasound in medicine & biology, vol. 24, no. 9, pp. 1325-1335, 1998.
[40] J. M. Meinders, L. Kornet, P. J. Brands, and A. P. Hoeks, "Assessment of local pulse wave velocity in arteries using 2D distension waveforms," Ultrasonic imaging, vol. 23, no. 4, pp. 199-215, 2001.
[41] A. Eriksson, E. Greiff, T. Loupas, M. Persson, and P. Pesque, "Arterial pulse wave velocity with tissue Doppler imaging," Ultrasound in medicine & biology, vol. 28, no. 5, pp. 571-580, 2002.
[42] J. Luo and E. E. Konofagou, "A fast normalized cross-correlation calculation method for motion estimation," IEEE transactions on ultrasonics, ferroelectrics, and frequency control, vol. 57, no. 6, pp. 1347-1357, 2010.
[43] J. Vappou, J. Luo, and E. E. Konofagou, "Pulse wave imaging for noninvasive and quantitative measurement of arterial stiffness in vivo," American journal of hypertension, vol. 23, no. 4, pp. 393-398, 2010.
[44] K. Fujikura et al., "A Novel Noninvasive Technique for Pulse-Wave Imaging and Characterization of Clinically-Significant Vascular Mechanical Properties In Vivo," Ultrasonic Imaging, vol. 29, no. 3, pp. 137-154, 2016.
[45] J. Luo, R. X. Li, and E. E. Konofagou, "Pulse wave imaging of the human carotid artery: an in vivo feasibility study," IEEE Trans Ultrason Ferroelectr Freq Control, vol. 59, no. 1, pp. 174-81, Jan 2012.
[46] R. X. Li, J. Luo, S. K. Balaram, F. A. Chaudhry, D. Shahmirzadi, and E. E. Konofagou, "Pulse wave imaging in normal, hypertensive and aneurysmal human aortas in vivo: a feasibility study," Phys Med Biol, vol. 58, no. 13, pp. 4549-62, Jul 7 2013.
[47] R. Nagaoka, G. Masuno, K. Kobayashi, S. Yoshizawa, S. Umemura, and Y. Saijo, "Measurement of regional pulse-wave velocity using spatial compound imaging of the common carotid artery in vivo," Ultrasonics, vol. 55, pp. 92-103, Jan 2015.
[48] I. Z. Apostolakis, S. D. Nandlall, and E. E. Konofagou, "Piecewise Pulse Wave Imaging (pPWI) for Detection and Monitoring of Focal Vascular Disease in Murine Aortas and Carotids In Vivo," IEEE Trans Med Imaging, vol. 35, no. 1, pp. 13-28, Jan 2016.
[49] X. Li et al., "Measurement of carotid pulse wave velocity using ultrafast ultrasound imaging in hypertensive patients," Journal of Medical Ultrasonics, vol. 44, no. 2, pp. 183-190, 2017.
[50] F. W. Kremkau, Sonography principles and instruments. Elsevier Health Sciences, 2015.
[51] K. K. Shung, Diagnostic ultrasound: Imaging and blood flow measurements. CRC press, 2005.
[52] D. H. Evans, J. A. Jensen, and M. B. Nielsen, "Ultrasonic colour Doppler imaging," Interface focus, vol. 1, no. 4, pp. 490-502, 2011.
[53] M. Butlin and A. Qasem, "Large artery stiffness assessment using SphygmoCor technology," Pulse, vol. 4, no. 4, pp. 180-192, 2016.
[54] E. Hermeling, K. D. Reesink, R. S. Reneman, and A. P. Hoeks, "Measurement of local pulse wave velocity: effects of signal processing on precision," Ultrasound Med Biol, vol. 33, no. 5, pp. 774-81, May 2007.
[55] Y. Li, A. Borlotti, S. S. Hickson, C. M. McEniery, I. B. Wilkinson, and A. W. Khir, "Using magnetic resonance imaging measurements for the determination of local wave speed and arrival time of reflected waves in human ascending aorta," Conf Proc IEEE Eng Med Biol Soc, vol. 2010, pp. 5153-6, 2010.
[56] M. Negoita, A. D. Hughes, K. H. Parker, and A. W. Khir, "A method for determining local pulse wave velocity in human ascending aorta from sequential ultrasound measurements of diameter and velocity," Physiol Meas, vol. 39, no. 11, p. 114009, Nov 26 2018.
[57] I. I. B. Nenova, "Online Digital Filters Applicable to Fast Pulse Wave Detection," Annual Journal of Electronics, 2009.
[58] B. Nenova and I. Iliev, "An automated algorithm for fast pulse wave detection," International Journal Bioantomation, vol. 14, no. 3, pp. 203-216, 2010.
[59] E. Hermeling, K. D. Reesink, L. M. Kornmann, R. S. Reneman, and A. P. G. Hoeks, "The dicrotic notch as alternative time-reference point to measure local pulse wave velocity in the carotid artery by means of ultrasonography," (in English), Journal of Hypertension, vol. 27, no. 10, pp. 2028-2035, Oct 2009.
[60] F. B. Li, Q. He, C. W. Huang, K. Liu, J. H. Shao, and J. W. Luo, "High frame rate and high line density ultrasound imaging for local pulse wave velocity estimation using motion matching: A feasibility study on vessel phantoms," (in English), Ultrasonics, vol. 67, pp. 41-54, Apr 2016.
[61] J. Fromageau, J. L. Gennisson, C. Schmitt, R. L. Maurice, R. Mongrain, and G. Cloutier, "Estimation of polyvinyl alcohol cryogel mechanical properties with four ultrasound elastography methods and comparison with gold standard testings," IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, vol. 54, no. 3, pp. 498-509, 2007.
[62] L. Tian and N. C. Chesler, "In vivo and in vitro measurements of pulmonary arterial stiffness: A brief review," Pulm Circ, vol. 2, no. 4, pp. 505-17, Oct 2012.