Quantitative imaging in medicine and surgery · 2025
Perioperative alteration of posterior tibial artery perfusion by contrast-enhanced ultrasound in patients with peripheral artery disease after endovascular therapy.
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Ding Chunhong, Chai Qiliang, Zhu Jun, Liu Yingchun, Zhou Keqian, Du Yutong, Cui Jiasen, Li Li, Zhang Wan, Chen Lin
Аннотация
BACKGROUND: Contrast-enhanced ultrasound (CEUS) has potential applications in both the diagnosis and perioperative quantification of distal limb microcirculation in patients with peripheral artery disease (PAD). This study aimed to evaluate the perioperative changes and potential clinical utility of the luminal perfusion parameters of the posterior tibial artery (PTA) assessed by CEUS in PAD patients who had undergone endovascular therapy (EVT).
METHODS: We retrospectively reviewed the hospitalization records of PAD patients who underwent EVT, and pre- and post-EVT CEUS at a single center between January 2020 and February 2022. The perioperative CEUS perfusion parameters and peak systolic velocity (PSV) of the PTA were recorded. The CEUS perfusion parameters included peak intensity (PI), time to peak (TTP), mean transit time (MTT), slope, area, area wash in (AWI), and area wash out (AWO). Paired samples t-tests or Wilcoxon rank-sum tests were used to compare differences in PSV and the CEUS perfusion parameters pre- and post-EVT. A Spearman correlation analysis was conducted to examine the correlations between PSV and the CEUS perfusion parameters.
RESULTS: A total of 43 consecutive patients with PAD (in 43 limbs) were included in the study. After EVT, PSV significantly improved from 26.27±21.03 to 49.01±25.79 cm/s (P<0.001). The TTP decreased from 11.74±8.20 to 7.01±3.12 s (P<0.001), the MTT decreased from 23.00±11.51 to 18.16±7.87 s (P=0.002), and the slope increased from 19.01±23.04 to 32.56±54.18 ×10-5 AU/s (P=0.025). The perfusion parameters exhibited weak correlations with PSV (maximum |rs|=0.405, P<0.05).
CONCLUSIONS: Based on CEUS, the perfusion of the PTA in the PAD patients improved significantly post-EVT. CEUS of the PTA provided detailed insights into EVT-induced hemodynamic changes at the arterial level, supporting its potential integration into clinical practice as an adjunct imaging tool.
METHODS: We retrospectively reviewed the hospitalization records of PAD patients who underwent EVT, and pre- and post-EVT CEUS at a single center between January 2020 and February 2022. The perioperative CEUS perfusion parameters and peak systolic velocity (PSV) of the PTA were recorded. The CEUS perfusion parameters included peak intensity (PI), time to peak (TTP), mean transit time (MTT), slope, area, area wash in (AWI), and area wash out (AWO). Paired samples t-tests or Wilcoxon rank-sum tests were used to compare differences in PSV and the CEUS perfusion parameters pre- and post-EVT. A Spearman correlation analysis was conducted to examine the correlations between PSV and the CEUS perfusion parameters.
RESULTS: A total of 43 consecutive patients with PAD (in 43 limbs) were included in the study. After EVT, PSV significantly improved from 26.27±21.03 to 49.01±25.79 cm/s (P<0.001). The TTP decreased from 11.74±8.20 to 7.01±3.12 s (P<0.001), the MTT decreased from 23.00±11.51 to 18.16±7.87 s (P=0.002), and the slope increased from 19.01±23.04 to 32.56±54.18 ×10-5 AU/s (P=0.025). The perfusion parameters exhibited weak correlations with PSV (maximum |rs|=0.405, P<0.05).
CONCLUSIONS: Based on CEUS, the perfusion of the PTA in the PAD patients improved significantly post-EVT. CEUS of the PTA provided detailed insights into EVT-induced hemodynamic changes at the arterial level, supporting its potential integration into clinical practice as an adjunct imaging tool.