Study of the effects of flow acceleration on blood aggregation by high frequency duplex ultrasound: Under pulsatile flow

Yu-Chang Chang, Po-Yang Lee, Chen-Chih Liao, Chih-Chung Huang
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Abstract

The echogenicity of whole blood is known to vary during the flow cycle under pulsatile flow both in vitro and in vivo. However, the fundamental underlying mechanisms remain uncertain. The cyclic variations of high frequency ultrasonic backscattering signals have been measured for explaining the temporal variations of red blood cells (RBCs) aggregation under pulsatile flow. The level of RBC aggregation was enhanced by reducing the flow velocity. However, the size of rouleau still increased during the flow acceleration phase. This observation is opposite to previous studies which the formation of rouleau should be broke up by increasing the shear force of flow. In order to further explore this phenomenon, the effect of flow acceleration on RBC aggregation was studied by high frequency duplex ultrasound. The experiments were performed on porcine whole blood with different hematocrits from 20 to 40%. The blood was circulated in a pulsatile Couette flow apparatus under different flow accelerations. Both ultrasound M-mode images and Doppler flow information from flowing blood were obtained by the 35 MHz and 30 MHz transducers, respectively. The backscattering signals and Doppler flow velocities were acquired synchronously to compare the relationship between flow acceleration and blood aggregation. The results indicated that the cyclic variations became weaker as the stroke rate increased and the variation was higher for a hematocrit of 40% than for one of 20%. However, the cyclic variation became stronger with increase of peak flow velocity. The flow velocity between 10 to 20 cm/s can be treated as a threshold for rouleaux disaggregation under pulsatile flow during the acceleration phase.
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脉动流下高频双工超声研究血流加速对血液聚集的影响
在体外和体内,全血的回声性在脉动血流循环过程中是不同的。然而,基本的潜在机制仍然不确定。测量了高频超声后向散射信号的周期变化,以解释脉动流下红细胞聚集的时间变化。红细胞聚集水平通过降低血流速度而增强。然而,在流动加速阶段,涡流的大小仍在增加。这一观察结果与以往的研究相反,以前的研究认为,应该通过增加流动的剪切力来破坏rouleau的形成。为了进一步探讨这一现象,我们利用高频双工超声研究了血流加速对红细胞聚集的影响。实验用不同血细胞比容的猪全血(20% ~ 40%)进行。血液在脉动式库埃特血流仪中以不同的血流加速度循环。35 MHz和30 MHz的换能器分别获得血流的超声m型图像和多普勒血流信息。同步获取后向散射信号和多普勒血流速度,比较血流加速与血液聚集的关系。结果表明,随着中风率的增加,循环变化变弱,红细胞比容为40%时比20%时变化更大。但随着峰值流速的增加,循环变化越来越强。在加速阶段,10 ~ 20 cm/s的流速可以作为脉动流下rouleaux解体的阈值。
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