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|Title:||An in vitro comparison of embolus differentiation techniques for clinically significant macroemboli : dual-frequency technique versus frequency modulation method|
Ramnarine, K. V.
Evans, D. H.
Chung, Emma Ming Lin
|Publisher:||Elsevier for World Federation for Ultrasound in Medicine and Biology|
|Citation:||Ultrasound in Medicine and Biology, 2014, 40 (11), pp. 2642-2654|
|Abstract:||The ability to distinguish harmful solid cerebral emboli from gas bubbles intra-operatively has potential to direct interventions to reduce the risk of brain injury. In this in vitro study, two embolus discrimination techniques, dual-frequency (DF) and frequency modulation (FM) methods, are simultaneously compared to assess discrimination of potentially harmful large pieces of carotid plaque debris (0.5-1.55 mm) and thrombus-mimicking material (0.5-2 mm) from gas bubbles (0.01-2.5 mm). Detection of plaque and thrombus-mimic using the DF technique yielded disappointing results, with four out of five particles being misclassified (sensitivity: 18%; specificity: 89%). Although the FM method offered improved sensitivity, a higher number of false positives were observed (sensitivity: 72%; specificity: 50%). Optimum differentiation was achieved using the difference between peak embolus/blood ratio and mean embolus/blood ratio (sensitivity: 77%; specificity: 81%). We conclude that existing DF and FM techniques are unable to confidently distinguish large solid emboli from small gas bubbles (<50 μm).|
|Rights:||Copyright © 2014 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/3.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
|Appears in Collections:||Published Articles, Dept. of Cardiovascular Sciences|
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