Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Flashlight-Sign: a Novel B-Flow Based Ultrasound Finding for Detection of Intraluminal, Wall-Adherent, Floating Structures of the Abdominal Aorta and Peripheral Arteries

Version 1 : Received: 10 May 2022 / Approved: 11 May 2022 / Online: 11 May 2022 (03:44:41 CEST)

A peer-reviewed article of this Preprint also exists.

Lottspeich, C.; Puhr-Westerheide, D.; Stana, J.; Hoffmann, U.; Czihal, M. The Flashlight-Sign: A Novel B-Flow Based Ultrasound Finding for Detection of Intraluminal, Wall-Adherent, Floating Structures of the Abdominal Aorta and Peripheral Arteries. Diagnostics 2022, 12, 1708. Lottspeich, C.; Puhr-Westerheide, D.; Stana, J.; Hoffmann, U.; Czihal, M. The Flashlight-Sign: A Novel B-Flow Based Ultrasound Finding for Detection of Intraluminal, Wall-Adherent, Floating Structures of the Abdominal Aorta and Peripheral Arteries. Diagnostics 2022, 12, 1708.

Abstract

This study aimed on evaluating the potential diagnostic value of a novel, sonographic, B-Flow Imaging (BFI)-based sign (“flashlight sign”, FLS) for the detection of wall-adherent, floating arterial structures (WAFAS). The FLS, characterized by a fast moving, very bright, intraluminal signal was detected in 28 patients with WAFAS. We divided this cohort into three subgroups, depending on the affected vascular segments: (1) peripheral arteries (n = 10), (2) native abdominal aorta (n = 8), and (3) abdominal aorta after endovascular aortic repair (EVAR; n = 10). Clinical characteristics were analyzed and BFI-findings were compared with contrast enhanced ultrasound (CEUS) and computed tomography angiography (CTA). Seven patients (25%) suffered from arterial embolism downstream to the FLS (EVAR, n = 4; native abdominal aorta, n = 1; peripheral arteries, n = 2). WAFAS of the abdominal aorta (native or after EVAR), as indicated by the FLS, were visible by CEUS and CTA in 60% and 93.3%, respectively. Based on the so far largest cohort of patients with WAFAS, we propose a clinically useful, BFI-based sonographic sign for detection of these so far underrated arterial pathologies in the abdominal aorta and the peripheral arteries.

Keywords

abdominal aorta; arterial embolism; B-Flow sonography; contrast enhanced ultrasound; endovascular aortic repair; flashlight sign; peripheral arteries; wall adherent floating structures

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

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