High-resolution ultrasound elasticity imaging to evaluate dialysis fistula stenosis

Accurate, noninvasive characterization of arterial wall mechanics and detection of fibrotic vascular lesions could vastly improve the ability to predict patient response to local treatments such as angioplasty. Current imaging and other techniques for determining wall compliance rely on imprecise or indirect estimates of wall motion. This study used high-resolution ultrasound imaging with phase-sensitive speckle tracking to obtain detailed and direct measurements of arterial stiffness in two subjects with dialysis fistula dysfunction. In both subjects, the absolute values of strain were much higher in normal regions of fistula than in regions of stenosis. The lower values of strain in stenotic fistula indicate greater stiffness of the vessel wall. The ultrasound speckle tracking technique used here may have potential to determine vascular mechanical properties noninvasively with a level of precision and accuracy not currently available.