Revealing Intraosseous Blood Flow in the Human Tibia With Ultrasound

Sébastien Salles, Jami Shepherd, Hendrik J. Vos, Guillaume Renaud*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Intraosseous blood circulation is thought to have a critical role in bone growth and remodeling, fracture healing, and bone disorders. However, it is rarely considered in clinical practice because of the absence of a suitable noninvasive in vivo measurement technique. In this work, we assessed blood perfusion in tibial cortical bone simultaneously with blood flow in the superficial femoral artery with ultrasound imaging in five healthy volunteers. After suppression of stationary signal with singular-value-decomposition, pulsatile blood flow in cortical bone tissue is revealed, following the heart rate measured in the femoral artery. Using a method combining transverse oscillations and phase-based motion estimation, 2D vector flow was obtained in the cortex of the tibia. After spatial averaging over the cortex, the peak blood velocity along the long axis of the tibia was measured at four times larger than the peak blood velocity across the bone cortex. This suggests that blood flow in central (Haversian) canals is larger than in perforating (Volkmann's) canals, as expected from the intracortical vascular organization in humans. The peak blood velocity indicates a flow from the endosteum to the periosteum and from the heart to the foot for all subjects. Because aging and the development of bone disorders are thought to modify the direction and velocity of intracortical blood flow, their quantification is crucial. This work reports for the first time an in vivo quantification of the direction and velocity of blood flow in human cortical bone.

Original languageEnglish
Article numbere10543
JournalJBMR Plus
Issue number11
Early online date1 Sept 2021
Publication statusPublished - Nov 2021

Bibliographical note

Funding Information:
This work was funded by a French ANR program (project FUIBCA ANR‐17‐CE19‐0008‐01) and by SATT LUTECH (project BONES).

Publisher Copyright:
© 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.


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