Key result
Ultrasound strain elastography identified significant differences among peripheral arterial disease lesions, with mean strain highest in soft plaques (0.63%) and mean strain ratio highest in calcified plaques (2.33%).
Why the study?
Arterial stiffness and steno-occlusion of the lower extremity can result from varied vascular lesions, and this study aimed to evaluate arterial lesion characteristics using ultrasound elastography.
Does ultrasound elastography differentiate between lesion types in patients with peripheral arterial disease?
Observational (n=20)
No
Does ultrasound elastography differentiate between lesion types in patients with peripheral arterial disease?
Ultrasound strain elastography demonstrates distinct strain and strain ratio profiles for different vascular lesions, suggesting utility in differentiating thrombus and plaque types in peripheral arterial disease.
Answers are grounded in this paper and cite their sources.
Vascular US elastography may aid lesion differentiation in PAD; leaves open its clinical utility pending prospective validation.
Purpose: Arterial stiffness and steno-occlusion of the lower-extremity can result from many vascular lesions, including acute thromboembolisms, soft plaques, calcified plaques, or inflammatory disease. Ultrasound (US) elastography measures the tissue deformation response to compression and displays tissue stiffness. This study aimed to evaluate the characteristics of arterial lesions in the lower extremities using US elastography. Materials and Methods: We retrospectively analyzed the data of 20 patients who visited our institute for arterial disease treatment between May 2016 and November 2017. An US examination with B-mode and strain elastography (SE) was performed of four different lesion types at 45 sites: acute and subacute thromboembolisms, soft plaques, calcified plaques, and thromboangiitis obliterans lesions (TAOs). During SE, stress was externally applied by the operator using the transducer. Strain ratio (SR) was calculated as the fraction of the average strain in the reference area divided by the average strain in the lesion. The SR was compared among different lesion types, with the accompanying vein as the reference region of interest. Results: The strain was highest in the soft plaques (0.63%±0.23%), followed by the TAOs (0.45%±0.11%), calcified plaques (0.44%±0.13%), and acute thromboembolisms (0.34%±0.23%), which were statistically significant (P=0.026). However, the mean SR was highest for the calcified plaques (2.33%±0.80%), followed by the TAOs (1.63%±0.40%), acute thromboembolisms (1.60%±0.48%), and soft plaques (1.51±0.39), and which were statistically significant (P=0.013). Conclusion: Despite several limitations, vascular elastography may be useful for differentiating between lesion types in peripheral arterial disease.
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Kim et al. (2022) conducted an observational in Peripheral arterial disease (n=20). Ultrasound strain elastography vs. Reference region of interest (accompanying vein or proximal normal segment) was evaluated on Strain ratio (SR) among different lesion types (p=0.013). Ultrasound strain elastography identified significant differences among peripheral arterial disease lesions, with mean strain highest in soft plaques (0.63%) and mean strain ratio highest in calcified plaques (2.33%).
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