Citations

ABSTRACT Carpal tunnel pressure is a key factor in the etiology of carpal tunnel syndrome. Numerous approaches have been conducted to measure carpal tunnel pressure. However, most techniques are invasive and take time and effort. We have developed an innovative approach to noninvasively assess the tunnel pressure by using the ultrasound surface wave elastography (USWE) technique. In a previous study it was shown that the shear wave speed in a tendon increased linearly with increasing tunnel pressure enclosed the tendon in a simple tendon model. This study aimed to examine the relationship between the carpal tunnel pressure and the shear wave speeds inside and outside the carpal tunnel in a human cadaveric model. The result showed that the shear wave speed inside the carpal tunnel increased linearly with created carpal tunnel pressure, while the shear wave speed outside the carpal tunnel remained constant. These findings suggest that noninvasive measurement of carpal tunnel pressure is possible by measuring the shear wave speed in the tendon. After fully establishing this technology and being applicable in clinic, it would be useful in the diagnosis of carpal tunnel syndrome. For that reason, further validation with this technique in both healthy controls and patients with carpal tunnel syndrome is required. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:477–483, 2018.

Ultrasonography is not widely used in clinic for lung assessment because ultrasound cannot image deep lung tissue. In this abstract, we present a novel technique, lung ultrasound surface wave elastography (LUSWE), for measuring the elastic properties of superficial lung tissue. In LUSWE, a small, local, and 0.1 second harmonic vibration is generated on the chest of a subject. The speed of surface wave on the lung is measured by using an ultrasound probe. We are evaluating LUSWE for assessing patients with interstitial lung disease (ILD). LUSWE may be useful for assessing ILD because most ILD patients have typical fibrotic scars in the peripheral and subpleural regions of the lung. In a large clinical study of ILD patients, we measure both lungs through six intercostal spaces for patients and controls. The surface wave speed is measured at 100 Hz, 150 Hz, and 200 Hz. In an example, the surface wave speed is 1.88 ± 0.11 m/s and 3.3 ± 0.37 m/s, respectively, for a healthy subject and an ILD patient at 100 Hz and in the same intercostal space. LUSWE may compliment the clinical standard high-resolution computed tomography for assessing ILD. LUSWE may be useful for assessing other lung disorders.

The purpose of this Letter to the Editor is to demonstrate an effective method for estimating viscoelasticity based on measurements of the Rayleigh surface wave speed. It is important to identify the surface wave mode for measuring surface wave speed. A concept of start frequency of surface waves is proposed. The surface wave speeds above the start frequency should be used to estimate the viscoelasticity of tissue. The motivation was to develop a noninvasive surface wave elastography (SWE) technique for assessing skin disease by measuring skin viscoelastic properties. Using an optical based SWE system, the author generated a local harmonic vibration on the surface of phantom using an electromechanical shaker and measured the resulting surface waves on the phantom using an optical vibrometer system. The surface wave speed was measured using a phase gradient method. It was shown that different standing wave modes were generated below the start frequency because of wave reflection. However, the pure symmetric surface waves were generated from the excitation above the start frequency. Using the wave speed dispersion above the start frequency, the viscoelasticity of the phantom can be correctly estimated.

In conventional shear wave elastography materials are assumed to be linear, elastic, homogeneous, and isotropic. These assumptions are important to account for in certain tissues because they are not always appropriate. Many tissues such as skeletal muscle, the kidney, and the myocardium are anisotropic. Shear waves can be used to investigate the directionally dependent mechanical properties of anisotropic media. To study these tissues in a systematic way and to account for the effects of the anisotropic architecture, laboratory-based phantoms are desirable. We will report on several phantom-based approaches for studying shear wave anisotropy, assuming that these materials are transversely isotropic. Phantoms with embedded fibers were used to mimic anisotropic tissues. Homogeneous phantoms were compressed to induce transverse isotropy according to the acoustoelastic phenomenon, which is related to nonlinear behavior of the materials. The fractional anisotropy of these phantoms was quantified to compare with measurements made in soft tissues. In addition, soft tissues are also viscoelastic, and we have developed a method to model viscoelastic transversely isotropic materials with the finite element method (FEM). The viscoelastic property estimation from phantom experiments and FEM simulations will also be discussed.

The mechanical response of tissues to external forces has gained considerable interest in medical diagnosis. One approach of imaging the tissue elastic properties is to apply an external force on the surface of the body. Another approach is to generate a localized force inside the tissue with the radiation force of ultrasound. In this paper, a noninvasive method for imaging the vibration mode of an object is investigated. The radiation force of ultrasound is used to scan the object at a resonant frequency of the object. The vibration of the object is measured by laser and the resulting acoustic emission from the object is measured by a hydrophone. Experimental studies are carried out on a mechanical heart valve and arterial phantoms. The mode images on the valve are made by the hydrophone measurement and confirmed by FEM simulations. Compared with conventional B-scan imaging on arterial phantoms, the mode imaging can show not only the interface of the artery and the gelatin, but also the vibration modes of the artery. The images taken on the phantom surface suggest that an image of an interior artery can be made by vibration measurements on the surface of the body.

Increased stiffness of arteries has recently gained acceptance as an independent risk factor for cardiovascular and many other diseases. Pulse wave velocity (PWV) is widely used for estimating the stiffness of an artery. However, PWV is an average indicator of artery stiffness between the two measuring points, and therefore does not identify local stiffness. In addition, the thickness of the artery is needed to calculate artery elastic modulus. We have discovered that there is a series of ring resonant frequency in arteries that can be used for estimating local arterial elastic modulus. These resonances can be excited by remote palpation with selectively placed ultrasonic radiation force. Experiments on ring resonance were carried out on an excised artery as well as a rubber tube. This family of resonances occurs at relatively low frequency, around 356 Hz for the artery. Estimation of the Young’s modulus is 135 kPa by the ring frequency 356 Hz without the requirement of the arterial thickness. The estimated modulus is very consistent with the other ring resonant frequency measurements. The theory of ring resonance is developed and verified with the rubber tube experiments.

We have proposed generating a bending wave in the arterial wall using ultrasound radiation force and measuring the wave velocity along the arterial wall [Zhang et al., IEEE Trans. Ultrason. Ferroelectr. Freq. Control 52, 642–652 (2005)]. Here, we report the results of in vivo studies on pigs. The pig was anesthetized, and a micromanometer tip catheter was inserted into the femoral artery to measure luminal pressure. A water bath was created on the animal’s groin to allow unimpeded access of the ultrasound beams to the femoral artery. The femoral artery was first located using a 13-MHz linear-array transducer. Then, a vibro-acoustography image was obtained to ensure precise positioning of the excitation force relative to the artery. The artery was excited by the force transducer and the resulting vibration of the arterial wall was measured by a sensing Doppler transceiver. Measured wave velocity was 3.1 m/s at 300 Hz. With this new method wave velocity over a distance of 5 mm, and therefore stiffness of arteries, can be measured locally and non-invasively. Measurement time is short in a few tens of milliseconds, which allows pressure dependence and pharmacological effect on the wall properties to be measured at different cardiac times.

Arterial wall stiffness can be associated with various diseases. The stiffness of an artery can be assessed by measurement of the pulse wave velocity (PWV). PWV is directly related to the Youngs modulus by the well-known Moens–Korteweg equation. Usually, PWV is estimated using the foot-to-foot method. However, the foot of the pressure wave is not very clear due to reflected waves. Also, the pressure wave is normally at a low frequency, hence, the time resolution is low. PWV is an average indicator of artery stiffness between the two measuring points, therefore it is not easy to identify local stiffness. We propose producing a very short pulse wave in the arterial wall using ultrasound radiation force and measuring its propagation speed along the artery by laser. The temporal resolution of this method is in the range of microseconds, which allows PWV to be measured accurately over a few millimeters. Experiments were carried out on a silicone tube in gelatin. PWV was measured by two scanning methods: (1) fixed source and scanning detector, (2) scanning source and fixed detector. Results: PWV was measured at 2 mm/40 μs by both methods. The Doppler technique was also tested which is potentially suitable for clinical applications.

Vibro-acoustography is a new noncontact imaging method based on the radiation force of ultrasound. We extend this technique for imaging of arterial vessels based on vibration resonance. The arterial vessel is excited remotely by ultrasound at a resonant frequency, at which the vibration of the vessel as well as its transmission to the body surface are large enough to be measured. By scanning the ultrasound beam across the vessel plane and measuring the vibration at one single point on the body or vessel surface, an image of the interior artery can be mapped. Theory is developed that predicts the measured velocity is proportional to the value of the mode shape at resonance. Experimental studies were carried out on a silicone tube embedded in a cylindrical gel phantom of large radius, which simulates a large artery and the surrounding body. The fundamental frequency was measured at which the ultrasound transducer scanned across the tube plane with velocity measurement at one single point on the tube or on the phantom by laser. The images obtained show clearly the interior tube and the modal shape of the tube. The present technique offers a new imaging method for arterial vessels.

Vibro-acoustography is a new noncontact imaging method based on the radiation force of ultrasound. We extend this technique for tissue characterization of arterial tubes by vibration techniques. The arterial tube can be excited remotely by ultrasound at its resonant frequencies where the vibration and acoustic emission of the tube can be measurable. From these resonant frequencies, the material properties of the arterial tube can be found. A theory for a tube with tissue is formulated using first-order shear deformation theory to include the effects of transverse shear deformation and rotary inertia. A wave propagation approach is applied for easy handling of the boundary conditions. Experimental studies were carried out on a silicone tube embedded in a cylindrical gel phantom. A confocal transducer is used to produce the radiation force of ultrasound for exciting the tube–phantom structure. The vibration of the tube and the phantom are measured with a laser vibrometry system. The fundamental mode of a tube–phantom structure is well excited by the radiation force of ultrasound, and was measured to be 81.8 Hz, which is close to the theoretical prediction of 83.3 Hz. Both excitation and measurement are remote and noncontact, important attributes for future study of arteries.