Keywords:
Abdomen, Extremities, Thyroid / Parathyroids, Ultrasound, Ultrasound-Colour Doppler, Ultrasound-Power Doppler, Diagnostic procedure, Blood
Authors:
G. Malferrari1, E. Papini2, A. batticciotto3, G. zhang4, A. Dell'Era5, L. Forzoni6, Y. Wang4, L. Zhou7, G. Bizzarri2; 1Reggio Emilia/IT, 2Albano Laziale/IT, 3Milano/IT, 4Harbin/CN, 5Genova/IT, 6Firenze/IT, 7Shanghai/CN
DOI:
10.1594/ecr2018/C-1428
Methods and materials
Seven patients were evaluated using microV (Esaote S.p.A.,
Genova,
Italy) in different clinical applications:
- Neurosonology: cerebral media artery stenosis;
- Endocrinology: thyroid nodules;
- Endocrinology: cervical lymph nodes;
- Liver: hepatic hemangioma;
- Kidney: renal cortex;
- Musculoskeletal/Rheuma: synovitis;
- Musculoskeletal/Rheuma: nail bed;
- Musculoskeletal/Rheuma: metatarsophalangeal joint evaluation in rheumatoid arthritis.
microV technology,
here assessed in comparison with Color and Power Doppler,
is a recently introduced hemodynamic evaluation technology especially dedicated for microvascular examinations,
slow flow with weak intensity,
also in depth.
microV is a technology present on all probes (Linear,
Convex,
Phased and Endocavity; See Figure 1) in all clinical applications available on the ultrasound systems used (MyLab9 eXP,
MyLab8 eXP and MyLabTwice eHD CrystaLine,
Esaote S.p.A.,
Genova,
Italy; See Figure 2).
microV technology (Fig.
3) is based on 6 main technical characteristics,
which differentiate microV with respect to other traditional bi-dimensional Doppler technology for the hemodynamic evaluation,
as Color or Power Doppler:
- High sensitivity to hemodynamic flows due to re-design and optimization of the filtering algorithms to discern blood flow signal from vessel wall.
The anti-clutter filtering was designed for the best achievable capabilities regarding low velocity signals and detection capability of movement artefacts;
- Strong insensitivity to noise (high signal to noise ratio) which enables high sensitivity and spatial definition also in depth.
Expanded dynamics implemented with separate action among visualization control components,
for an asymptotically linear power representation;
- High discrimination capability between hemodynamic signals and hyper-echoic structures: confident detection of tiny hemodynamic signals also among strong tissue echoes.
The expanded dynamics,
with separate action among visualization control components,
enables strong independency maximization with respect to elevated contrast/saturation structures too;
- Color palettes were expressly designed for a more accurate representation of the power signal values.
It is possible to choose from five different visualization algorithms to enhance spatial resolution,
blood volume flow and signal consistency;
- Visualization threshold dynamically adapted in order to ensure the detection and amplification of any signal which is not noise and which would be otherwise cancelled;
- B-Mode background suppression can be set in order to enhance the micro-vascularization signal.
Moreover,
the optimized impedance matching between the transducer and the system (being designed together and not re-adapted by third party projects) and the transducer and the patient body (due to the multiple matching layers present with the IQ Probe) ensures a high signal to noise ratio,
able to detect also tiny hemodynamic signals even in depth.