D. Righi

Bio: D. Righi is an academic researcher from University of Florence. The author has contributed to research in topics: Doppler effect & Carotid endarterectomy. The author has an hindex of 10, co-authored 20 publications receiving 338 citations. Previous affiliations of D. Righi include Roma Tre University.

Comparison of carotid artery blood velocity measurements by vector and standard Doppler approaches.

Abstract: Although severely affected by the angle dependency, carotid artery peak systolic velocity measurements are widely used for assessment of stenosis. In this study, blood peak systolic velocities in the common and internal carotid arteries of both healthy volunteers and patients with internal carotid artery stenosis were measured by two vector Doppler (VD) methods and compared with measurements obtained with the conventional spectral Doppler approach. Although the two VD techniques were completely different (using the transmission of focused beams and plane waves, respectively), the measurement results indicate that these techniques are nearly equivalent. The peak systolic velocities measured in 22 healthy common carotid arteries by the two VD techniques were very close (according to Bland-Altman analysis, the average difference was 3.2%, with limits of agreement of ± 8.6%). Application of Bland-Altman analysis to comparison of either VD technique with the spectral Doppler method provided a 21%-25% average difference with ± 13%-15% limits of agreement. Analysis of the results obtained from 15 internal carotid arteries led to similar conclusions, indicating significant overestimation of peak systolic velocity with the spectral Doppler method. Inter- and intra-operator repeatability measurements performed in a group of 8 healthy volunteers provided equivalent results for all of the methods (coefficients of variability in the range 2.7%-6.9%), even though the sonographers were not familiar with the VD methods. The results of this study suggest that the introduction of vector Doppler methods in commercial machines may finally be considered mature and capable of overcoming the angle-dependent overestimation typical of the standard spectral Doppler approach.

Interaction between secondary velocities, flow pulsation and vessel morphology in the common carotid artery.

Abstract: The common carotid artery (CCA), one of the vessels more frequently investigated by ultrasound (US), is often modeled as a straight tube in quasi-laminar flow regimens. Experimental investigations based on a prototype multigate system show that blood velocity profiles are parabolic during diastole and early systole, and flat during the systolic peak. However, during late systole/beginning of diastole, they have an "M" shape, where the velocity near the walls is higher than in the vessel center. Moreover, the profile shape changes when the sound beam direction is moved over a given cross-section; thus, suggesting a nonaxisymmetrical velocity distribution, which contradicts the straight tube assumption. The purpose of this paper was twofold. First, the actual velocity distribution in "normal" CCAs was reconstructed. The analysis of several velocity profiles confirms that the velocity distribution is markedly asymmetrical, especially during the deceleration phase following the systolic peak. Second, a tentative explanation for such behavior is given by correlating it with the growth of secondary flows caused by the slight vessel curvature and viscous effects. This explanation is supported by the comparison between in vitro results and numerical solution of the Navier–Stokes equations in laminar pulsed-flow regimens.

Differences between internal jugular vein and vertebral vein flow examined in real time with the use of multigate ultrasound color Doppler.

Abstract: BACKGROUND AND PURPOSE: The hypothesis that MS could be provoked by a derangement of the blood outflow from the brain has been largely discredited. In part, it was because data on the normal pattern of outflow are scarce and obtained with different methods. The aim of this study was to evaluate the normal pattern of outflow for the vertebral and internal jugular veins in healthy subjects with multigate color Doppler. MATERIALS AND METHODS: Twenty-five volunteers were studied to assess vessel area, mean velocity, and flow for the vertebral and internal jugular veins in the supine and sitting positions. RESULTS: In the sitting position, flow decreases, both in vertebral veins and internal jugular veins, as the total vessel area decreases (from 0.46 ± 0.57 to 0.09 ± 0.08 cm 2 ), even if the mean velocity increases (from 12.58 ± 10.19 to 24.14 ± 17.60 cm/s). Contrary to what happens to the blood inflow, outflow in the supine position, through vertebral and internal jugular veins, is more than twice the outflow in the sitting position (739.80 ± 326.32 versus 278.24 ± 207.94 mL/min). In the sitting position, on application of very low pressure to the skin with the sonography probe, internal jugular veins rarely appear to occlude. A pronounced difference of diameter between internal jugular veins was present in approximately one-third of subjects. CONCLUSIONS: Our results support the view that other outflow pathways, like the vertebral plexus, play a major role in the normal physiology of brain circulation and must be assessed to obtain a complete picture of blood outflow.

An FFT-based flow profiler for high-resolution in vivo investigations

Abstract: Pulsed Doppler spectral analysis is a well-established diagnostic technique in the assessment of arterial diseases. Because of hardware limitations, its use has been so far restricted to the analysis of a single sample volume located along the ultrasound beam axis. In this paper, we discuss the operation of a newly developed multigate instrument capable of performing, in real time, 64-point fast Fourier transforms of Doppler signals sampled from 64 different range cells. The new instrument is capable of accurately detecting the actual blood flow behavior in major human vessels. Significant examples of velocity profiles obtained in real time from carotid arteries in healthy subjects are reproduced here for the first time. Multigate extension of spectral analysis is demonstrated to be a suitable means for detailed in vivo investigation of blood flow dynamics.

On the interaction between ultrasound and contrast agents during Doppler investigations.

Abstract: Knowledge of interaction mechanisms between ultrasound (US) and contrast agents (CA) suspended in blood is important for a correct interpretation of clinical investigation results. Experiments performed in different laboratories have shown that, as a consequence of primary radiation force, CA tend to move away from the US transducer. Accordingly, Doppler spectra produced by particles suspended in moving water turn out to be significantly altered from what is theoretically expected. The purpose of this paper is twofold. First, an original model describing the bubble dynamics as the outcome of the balance between US radiation force and fluid drag force is validated for the case in which bubbles are suspended in blood. The high fluid viscosity is shown to prevent significant bubble deviations from the unperturbed fluid streamlines so that, in large vessels, a residual spectral distortion may exist only at the highest intensity levels permitted by current regulations. Finally, the relative importance and differences between the effect of primary radiation force and streaming mechanisms that, in principle, could lead to similar effects, are discussed.

Ultrafast imaging in biomedical ultrasound

Abstract: Although the use of ultrasonic plane-wave transmissions rather than line-per-line focused beam transmissions has been long studied in research, clinical application of this technology was only recently made possible through developments in graphical processing unit (GPU)-based platforms Far beyond a technological breakthrough, the use of plane or diverging wave transmissions enables attainment of ultrafast frame rates (typically faster than 1000 frames per second) over a large field of view This concept has also inspired the emergence of completely novel imaging modes which are valuable for ultrasound-based screening, diagnosis, and therapeutic monitoring In this review article, we present the basic principles and implementation of ultrafast imaging In particular, present and future applications of ultrafast imaging in biomedical ultrasound are illustrated and discussed

Ultrafast compound doppler imaging: providing full blood flow characterization

Abstract: Doppler-based flow analysis methods require acquisition of ultrasound data at high spatio-temporal sampling rates. These rates represent a major technical challenge for ultrasound systems because a compromise between spatial and temporal resolution must be made in conventional approaches. Consequently, ultrasound scanners can either provide full quantitative Doppler information on a limited sample volume (spectral Doppler), or averaged Doppler velocity and/or power estimation on a large region of interest (Doppler flow imaging). In this work, we investigate a different strategy for acquiring Doppler information that can overcome the limitations of the existing Doppler modes by significantly reducing the required acquisition time. This technique is called ultrafast compound Doppler imaging and is based on the following concept: instead of successively insonifying the medium with focused beams, several tilted plane waves are sent into the medium and the backscattered signals are coherently summed to produce high-resolution ultrasound images. We demonstrate that this strategy allows reduction of the acquisition time by a factor of up to of 16 while keeping the same Doppler performance. Depending on the application, different directions to increase performance of Doppler analysis are proposed and the improvement is quantified: the ultrafast compound Doppler method allows faster acquisition frame rates for high-velocity flow imaging, or very high sensitivity for low-flow applications. Full quantitative Doppler flow analysis can be performed on a large region of interest, leading to much more information and improved functionality for the physician. By leveraging the recent emergence of ultrafast parallel beamforming systems, this paper demonstrates that breakthrough performances in flow analysis can be reached using this concept of ultrafast compound Doppler.

Microbubble ultrasound contrast agents: a review.

Abstract: The superior scattering properties of gas bubbles compared with blood cells have made microbubble ultrasound contrast agents important tools in ultrasound diagnosis. Over the past 2 years they have become the focus of a wide and rapidly expanding field of research, with their benefits being repeatedly demonstrated, both in ultrasound image enhancement, and more recently in drug and gene delivery applications. However, despite considerable investigation, their behaviour is by no means fully understood and, while no definite evidence of harmful effects has been obtained, there remain some concerns as to their safety. In this review the existing theoretical and experimental evidence is examined in order to clarify the extent to which contrast agents are currently understood and to identify areas for future research. In particular the disparity between the conditions considered in theoretical models and those encountered both in vitro, and more importantly in vivo is discussed, together with the controversy regarding the risk of harmful bio-effects.

Ultrasound-induced encapsulated microbubble phenomena.

Abstract: When encapsulated microbubbles are subjected to high-amplitude ultrasound, the following phenomena have been reported: oscillation, translation, coalescence, fragmentation, sonic cracking and jetting. In this paper, we explain these phenomena, based on theories that were validated for relatively big, free (not encapsulated) gas bubbles. These theories are compared with high-speed optical observations of insonified contrast agent microbubbles. Furthermore, the potential clinical applications of the bubble-ultrasound interaction are explored. We conclude that most of the results obtained are consistent with free gas bubble theory. Similar to cavitation theory, the number of fragments after bubble fission is in agreement with the dominant spherical harmonic oscillation mode. Remarkable are our observations of jetting through contrast agent microbubbles. The pressure at the tip of a jet is high enough to penetrate any human cell. Hence, liquid jets may act as remote-controlled microsyringes, delivering a drug to a region-of-interest. Encapsulated microbubbles have (potential) clinical applications in both diagnostics and therapeutics.

ULA-OP: an advanced open platform for ultrasound research

Abstract: The experimental test of novel ultrasound (US) investigation methods can be made difficult by the lack of flexibility of commercial US machines. In the best options, these only provide beamformed radiofrequency or demodulated echo-signals for acquisition by an external PC. More flexibility is achieved in high-level research platforms, but these are typically characterized by high cost and large size. This paper presents a powerful but portable US system, specifically developed for research purposes. The system design has been based on high-level commercial integrated circuits to obtain the maximum flexibility and wide data access with minimum of electronics. Preliminary applications involving nonstandard imaging transmit/receive strategies and simultaneous B-mode and multigate spectral Doppler mode are discussed.