An in vitro study of the effects of Doppler angle, fibrinogen, and hematocrit on ultrasonic Doppler power

For a better understanding of the relationship between the Doppler power and erythrocyte aggregation of whole blood under steady flow in a conduit, the effects of Doppler angle, fibrinogen concentration, and hematocrit were investigated in a mock flow loop. The results show that, at a mean shear rate of 102 s(-1), there was minimal angular dependence; but at a mean shear rate of 52 s(-1), there was a weak angular dependence as the Doppler angle was varied from 40 degrees to 70 degrees . These results suggest that there was, perhaps, no or little alignment of the red cell aggregates at high shear rates. The Doppler power was found to increase nonlinearly as the fibrinogen concentration was increased; and the effect of other plasma proteins on red cell aggregation may not be negligible, although fibrinogen is the dominant factor. The results show that the variation of the Doppler power over the lumen is hematocrit dependent for hematocrits below 26%

In situ measurements of Doppler power vs. flow turbulence intensity in red cell suspensions

Whereas previous studies have shown that ultrasonic backscatter and Doppler power from blood are affected by flow turbulence, turbulence level has only been inferred from the flow Reynolds number and not directly measured. In this study, both ultrasonic Doppler power and flow turbulence intensity were measured in situ to quantify the relationship between Doppler power and flow turbulence. Three grid meshes of different geometries were used in a steady-flow mock loop to generate controlled levels of flow turbulence in porcine red blood cell saline suspensions. Doppler power was measured by a 10-MHz PW Doppler flowmeter, and the turbulence intensity by using constant-temperature hot film anemometry. We showed that Doppler power is affected by turbulence and hematocrit in a complex way. At a fixed hematocrit, Doppler power increases nonlinearly with turbulence intensity and, at fixed turbulence intensity, Doppler power peaks at an optimal hematocrit level that increases with turbulence level. The shape factor, introduced by Lucas and Twersky (1987) to take into account effects of shape and orientation of the scatterers in a dense distribution of small and tenuous scatterers, was estimated by fitting the experimental data to the theoretical model. The results indicate that shape factor decreases with increasing turbulence intensity.

Variation in ultrasonic backscattering from skeletal muscle during passive stretching

The purpose of this study was to further validate the scattering mechanism of ultrasound in the skeletal muscle tissue. It was hypothesized that the endomysial collagen fibers are a major determinant of ultrasonic scattering in the skeletal muscle. Previous studies have found that the ultrasonic backscattering from avian skeletal muscle changed as it was passively stretched from 0 to 40%. In this study, ultrasonic backscattering was measured from chicken breast muscles as they were stretched passively in increments of 10% of original length up to 60%. The integrated backscatter was found to reach a peak as the specimen was stretched to 40% and leveled off as it was further stretched from 40 to 60%. This finding was supported by results from scanning electron microscopy (SEM) of the specimens. SEM images showed that the orientation of the endomysial collagen fibers surrounding muscle fibers became approximately parallel to the axis of the muscle fiber when the muscle was stretched up to 40% of its original length, yielding maximal ultrasonic backscatter and as the muscle was further stretched, no apparent alteration of fiber orientation could be observed.

An approach for measuring ultrasonic backscattering from biological tissues with focused transducers

When the standard substitution method is used with a focused transducer to measure the backscattering coefficient from biological tissues including blood, it yields erroneous results. Extending the backscattering measurements to frequencies beyond 15 MHz necessitates the use of focused transducers because of the worsened signal-to-noise ratio--caused by the increased attenuation and the smaller transducer aperture size--in order to make the measurements close to the transducer. An approach which allows the use of focused transducers in backscattering measurements has been developed. It has been used to measure the backscattering coefficient of red cell suspensions of hematocrit ranging from a few percent to 30% in the frequency range from 5 MHz to 30 MHz. The results at hematocrits below 20% agree well with those obtained with the standard substitution method, although they differ as the hematocrit is increased beyond 20%. The experimental results also show that the fourth-power dependence of backscatter on frequency is in general approximately valid for suspended erythrocytes of hematocrit between 6% and 30%.

Hydrogels with enhanced mass transfer for transdermal drug delivery

The sonophoretic transport rates of monomeric insulin and vasopressin across human skin in vitro in the presence of a 20 kHz ultrasound field are shown to differ substantially depending on whether molecules enter the skin from a saline solution or from a viscous ultrasonic coupling medium (specifically, a methyl cellulose hydrogel or viscous sol). Theoretically, the reduction in sonophoretic transport caused by the hydrogels can be explained by boundary layers that form within the hydrogel owing to the relatively rapid rate of molecular transport across the (ultrasonically) permeated stratum corneum as well as poor diffusive mass transfer between the skin and gel. The results of in vitro experiments performed with an ac current accompanying the ultrasound show that the mass-transfer barrier posed by the hydrogel can be eliminated for both vasopressin and insulin by suppressing the diffusive boundary layers, indicating that relatively high rates of sonophoretic molecular transport across human skin are achievable when hydrogels are used as the ultrasound coupling medium as long as method is used to induce molecular mixing within the gel.

Quantitative measurements of second harmonic Doppler using ultrasound contrast agents

Quantitative measurements of second harmonic and first harmonic Doppler were carried out using two ultrasound contrast agents, Albunex and FS069. The RMS amplitudes of the Doppler shift spectra were measured as a function of the concentration of the agents, frequency and transmitted acoustic pressure. The results showed that, for a given lot of contrast agent investigated, FS069 was able to produce higher levels of first and, especially, second harmonic signals compared to Albunex. Under the same experimental conditions, the RMS Doppler amplitude (RDA) of FS069 was 3.8 +/- 0.8 dB higher than Albunex at first harmonic and 12.6 +/- 0.8 dB higher at second harmonic. The ratio of the second harmonic to first harmonic RDA, which we called R2/R1, decreases at a rate of 7 dB/MHz for both agents with increasing frequency. The difference in the value of R2/R1 between FS069 and Albunex at any frequency was approximately 4.5 dB. R2/R1 was found to increase linearly as a function of the transmitted acoustic pressure for both agents. Simulations using the Rayleigh-Plesset equation show a decrease of R2/R1 at a rate of 5 dB/MHz. Comparison of experimental results with theory indicates that the shell elasticity parameter may be an increasing function of the mean diameter of the bubbles.

Cyclic variation of Doppler power from whole blood under pulsatile flow

The echogenicity and Doppler power from whole blood under pulsatile flow have been found to vary during the flow cycle in previous studies both in vitro and in vivo. The present study was undertaken to better understand this phenomenon. Doppler power from whole blood under pulsatile flow was measured with a pulsed Doppler flowmeter as a function of the flow cycle, radial position and compliance of the vessel in a mock flow loop. It was found that the cyclic variation is more pronounced if the stroke rate is less than 56 beats/min and that the peak of the Doppler power from whole blood flowing near the center stream coincided with the peak of the flow velocity. However, it began to lead the velocity peak as the measurement site was moved away from the center stream. The lead increased as the radial distance was increased. The results also show that the compliance of the vessel can affect, to a certain extent, the magnitude of the cyclic variation. Results from intravascular Doppler measurements rule out the possibility that the cyclic variation is primarily due to the variation in attenuation caused by vessel wall during a flow cycle.

Some considerations on the measurements of mean frequency shift and integrated backscatter following administration of Albunex

Ultrasonic contrast agents have been of heightened interest in recent years. More success has been achieved by agents consisting of micro bubbles, since only a few of these agents are capable of producing very strong ultrasonic backscattered signals for the enhancement of certain tissue structures. Recent investigations also demonstrate that an analysis of the radio frequency (RF) backscattered echoes by the contrast agents may lead to quantitative means for assessing tissue perfusion. In these studies, a parameter, mean frequency shift (MFS) of the RF signal, along with integrated backscatter (IB) has received the most attention. In an effort to better understand the physical mechanisms responsible for the observed mean frequency shift, we have performed experiments on 10 dogs following injections of Albunex (Molecular Biosystems, Inc.) into the left atrium, coronary artery and abdominal aorta, respectively, for investigations in the heart and kidney. The integrated backscatter and mean frequency (MF) of a region of interest (ROI) were calculated from the RF signal acquired with a modified real-time ultrasonic scanner. The results show consistently that the RF signals acquired from all regions of interest are greatly affected by the presence of the contrast agent in the path between the transducer and the ROI, which can cause either an upward or a downward shift of the MF. This could not be observed by video densitometry or a measurement of the IB alone. The MFS is the result of the resonant behavior of the micro bubbles, which is related to the frequency, ambient pressure, and physical properties of the bubbles including size distribution, surface tension and concentration. On the other hand, when there is no contrast agent present in the path, a downward frequency shift is seen.

A study of the relationship between mechanical and ultrasonic properties of dystrophic and normal skeletal muscle

A study has been made of the application of radio frequency (RF) ultrasound to the detection of muscular dystrophy by monitoring passively stretched skeletal muscle. The tests included detection of integrated backscatter changes in response to both static loading, in which muscle samples were stretched and allowed to relax, and stress relaxation. In both static and step strain loading conditions, the dystrophic muscle was found to exhibit little change in backscatter power while normal muscle responded to loading with significant changes in integrated backscatter. The backscatter response is compared with mechanical properties of the tissue (time constants and stress-strain constants). Both mechanical and ultrasonic time constants of relaxation are not significantly different between normal and dystrophic tissue, but stress-strain constants do differ. The difference in response of dystrophic and normal tissue appears to be due to a repression of motion of the constituent anatomy of dystrophic muscle which is responsible for the change of echogenicity with passive stretch.

Time-domain ultrasonic contrast blood flowmetry

Time-domain ultrasonic blood flow estimation methods have recently received considerable attention because of their advantages over conventional Doppler methods. Among them are that they may yield better spatial resolution and that methods based on frame-to-frame speckle tracking do not require a knowledge of the angle between directions of blood flow and the ultrasound beam. These methods, however, suffer from an intrinsic problem of poor signal-to-noise ratio, since the echoes scattered back by blood are much weaker than those of the surrounding structures. In addition, the maximal velocity that can be estimated by frame-to-frame tracking via conventional ultrasonic scanners is limited by the frame rate of the scanner. In this article, we will present experimental results to show that these problems may be alleviated by using a high frame rate scanner in conjunction with the injection of an ultrasonic contrast agent. In this study the contrast agent used was Albunex.

Ultrasound scattering from blood with hematocrits up to 100%

The backscattering coefficient of saline suspensions of porcine red blood cells was measured for hematocrits up to about 90%. It was found that the coefficient peaks at approximately 15%, but then, contrary to what a simple "gap theory" might suggest, it decays smoothly to zero, without showing another peak at high hematocrits. A one-dimensional (1-D) slab scattering model, in which the number of slabs per unit length represents the hematocrit and whose thickness and acoustical properties are similar to red cells/plasma, was also used to investigate the relation between the backscattered power and hematocrit. Monte-Carlo simulations performed for randomized boundary conditions show a similar relation to that of the 3-D system. The experimental data is compared to the Percus-Yevick theory for the packing of hard spheres, and the simulated data is compared to the Percus-Yevick theory for infinite slabs.

A computer model for simulating ultrasonic scattering in biological tissues with high scatterer concentration

Scattering of ultrasonic waves by biological tissues at different scatterer concentrations is investigated using one- and two-dimensional computer simulation models. The backscattered power as a function of scatterer concentrations is calculated using two types of incident waves, a Gaussian shaped pulse and a continuous wave (CW). The simulation results are in good agreement with the Percus-Yevick packing theory within the scatterer concentrations, from 0% to 100% in one-dimensional (1D) space, and 0% to 46% in two-dimensional (2D) space. In all cases, the simulation results from a pulsed incident wave show a much smaller standard deviation (SD) than those from an incident CW. The simulation can serve as a useful tool to verify scattering theories, simulate different experimental conditions, and to investigate the interaction between the scatterer properties and the scattering of ultrasonic waves. More importantly, the 2D simulation procedure serves as an initial step toward the final realization of a true three-dimensional (3D) simulation of ultrasonic scattering in biological tissues.

High frequency ultrasonic backscatter from erythrocyte suspension

Previous studies have shown that ultrasonic backscattering from red blood cells suspended in saline is proportional to the fourth power of frequency for frequencies below 15 MHz, as predicted by Rayleigh scattering theory. Recently, we have extended the measurements up to 30 MHz, because scattering of ultrasound by red blood cells may no longer be negligible at these frequencies and can affect, to a great degree, the operation of intravascular imaging devices. The experimental results show that the fourth power dependence on frequency of the backscattering coefficient for porcine erythrocytes suspended in saline solution appears to be valid up to 30 MHz. To confirm this, backscattering cross-section of porcine red cells was computed as a function of frequency using the T-matrix method. Since at higher frequencies the shape of the scatterers may also play a significant role, its effect was investigated by treating the red cell as a sphere, a disc, and a biconcave disc of the same volume. Good agreement was obtained between the experimental and theoretical results.

Analysis of ultrasonic scattering in blood via a continuum approach

Since the pioneering work by Reid et al. on measuring ultrasonic scattering in blood, this phenomenon has been extensively studied both theoretically and experimentally. The knowledge on ultrasonic scattering properties of blood is needed for the design of ultrasonic methods for measuring blood flow, and a better interpretation of ultrasonic images. The development of high frequency intravascular or intracardiac imaging devices raises the possibility of measuring blood properties, e.g., erythrocyte aggregation and fibrinogen concentration, in situ. A number of theoretical approaches have been developed to analyze this phenomenon where in general ultrasound wavelength is much greater than the erythrocytes. These results show that the backscattering coefficient of blood, defined as power backscattered by a unit volume of blood per steradian per unit incident intensity, is proportional to variance of the erythrocyte number fluctuation and backscattering cross-section of a single erythrocyte. In this paper, we will show that similar results can also be obtained by taking a continuum approach.

Cyclic variation of the power of ultrasonic Doppler signals backscattered by polystyrene microspheres and porcine erythrocyte suspensions

Factors affecting the power of the ultrasonic Doppler signal within the flow cycle have been evaluated experimentally using a pulsatile flow loop model. Polystyrene microspheres and porcine red cells suspended in saline solution for hematocrits between 2 and 40% were used as scattering fluid in the flow model. Experiments were performed at mean flow velocities of 11, 64, and 76 cm/s. In laminar flow experiments performed at a mean velocity of 11 cm/s, no variation of the Doppler power was found for both polystyrene microspheres and red cell suspensions (40% hematocrit). When turbulence was induced in the flow model, the power increased during systole, a maximum was observed early after peak systole, and a decrease was obtained in diastole during deceleration of flow. At higher mean flow velocities (64 and 76 cm/s), a significant cyclic variation of the Doppler power was also measured for all values of hematocrits (between 2 and 40%). The power of the signal scattered by microspheres and red cell suspensions at 4% hematocrit dropped in systole, reached a minimum at peak systole, and then increased during early diastole. For red cells suspended in saline at 40% hematocrit, a slightly different pattern of variation was obtained. The cyclic variations observed at high flow velocities and in the presence of turbulence are believed to be associated with cyclic changes in the correlation among particles. In the present study, the effect of red cell aggregation on the cyclic variation has not been addressed.

Study of red cell aggregation in pulsatile flow from ultrasonic Doppler power measurements

Human red cell aggregability and disaggregability represent important hemorheological parameters of blood. Several techniques have been proposed to evaluate the tendency of red cells to form aggregates and to disrupt in the presence of shear stress. One of the most recent approaches is based on the characterization of the intensity of ultrasonic scattered signals. A pulsatile flow loop model is used in the present study to demonstrate the potential applicability of Doppler ultrasound to detect and characterize the hemodynamic behavior of red cell aggregates. Porcine whole blood specimens collected from 20 different pigs were circulated in the flow model (tube diameter of 0.476 cm) at different mean velocities and pulsation rates. At a pulsation of 70 beats/min for mean velocities of 13 cm/sec and 63 cm/sec, no cyclic variation of the Doppler power was observed, suggesting the absence of rouleaux build-up and rouleaux disruption. At a pulsation of 20 beats/min and mean velocities of 11 cm/sec and 38 cm/sec, statistically significant cyclic variations (p < 0.01) were measured. It is suggested that aggregate size enlargement, rouleaux orientation with the flow field and the effect of shear stress on rouleaux disruption are possible causes for the observed cyclic variation of the Doppler power within the flow cycle at a pulsation of 20 beats/min. A discussion of the potential application of this technique for in vivo study in large vessels is given.

Reverberation reduction in ultrasonic B-mode images via dual frequency image subtraction

The authors demonstrate the feasibility of an approach, dual-frequency subtraction imaging, for suppressing artifacts produced by reverberation of strong echoes among specular reflectors. This method is based upon the principle that specularly reflected echoes from flat boundaries are frequency-independent whereas the diffusely scattered echoes from small scatterers are frequency-dependent. The approach was assessed on phantoms including one consisting of two parallel plastic plates between layers of foam sponges using a prototype experimental system. Preliminary results show that this method is superior to simple thresholding techniques or signal compression and holds great promise for suppressing reverberation artifacts in ultrasonic images.

Scattering of ultrasound from skeletal muscle tissue

The purpose of this work was to explore the mechanisms which are responsible for the scattering of ultrasound from skeletal muscle tissue. It was undertaken in response to an interesting phenomenon observed in the authors' laboratory whereby scattering power from avian skeletal muscle changed in concordance with passive stretch. Ultrasonic scattering from skeletal muscle samples was measured as they were stretched passively in increments of 10% of their original length up to 40%. The samples were illuminated with an ultrasound beam from a transducer which was oriented orthogonally to and at 20 degrees from the normal to the long axis of the muscle sample. It was found that the integrated backscatter increased significantly over the strain range for the orthogonal orientation, but it changed very little after the initial stretch when the orientation was 20 degrees . It is postulated that this phenomenon may be caused by reorientation of the endomysial collagen fibers surrounding each muscle fiber.

A feasibility study on quantitating myocardial perfusion with Albunex, an ultrasonic contrast agent

Quantitating regional myocardial perfusion has been the much sought-after but still elusive goal of many intensive investigations over the years. Videodensitometry of the variation of myocardial echogenicity in two-dimensional (2-D) echocardiograms as a function of time in conjunction with the injection of a bolus of an ultrasound contrast agent has been used clinically as a tool for a direct assessment of regional myocardial perfusion, despite that the precise relationship between tissue echogenicity observed on an image and the echoes detected by the ultrasonic probe is unknown. A study was undertaken to determine whether ultrasonic backscatter calculated from unprocessed radio frequency (RF) echoes returned from myocardium could be used to quantitate regional myocardium perfusion. A real-time ultrasonic scanner has been modified and interfaced to a microcomputer to acquire RF data at a rate up to 10 frames per second. Preliminary experimental data were obtained from four open-chest dogs following intracoronary injection of a bolus of Albunex and two dogs following intravenous injection with this modified scanner. On one hand, these results indicate that the integrated backscatter measured from the region of myocardium perfused by the coronary artery where Albunex is injected and selected for monitoring initially increases, reaches a peak, and then decreases as the contrast agent is washed out and that the magnitude of the peak is approximately linearly proportional to the volume concentration of Albunex microspheres injected, clearly demonstrating the feasibility of this approach for quantitating region myocardial perfusion. On the other hand, intravenous injections did not result in any appreciable change in myocardial backscatter in the left ventricle although a response could be observed in the left ventricular blood pool.

Experimental evaluation of intrinsic and nonstationary ultrasonic Doppler spectral broadening in steady and pulsatile flow loop models

Intrinsic and nonstationary Doppler spectral broadening, and the skewness of the spectral representation, were evaluated experimentally using porcine red cell suspensions as ultrasonic scatterers. Theoretically, the relative Doppler bandwidth, defined as the intrinsic bandwidth divided by the mean Doppler frequency shift, should be velocity independent. The relative Doppler bandwidth invariance theorem was experimentally verified with an in vitro steady laminar blood flow model. It is shown that the relative bandwidth is both independent of the flow velocity and blood hematocrit. Using a pulsatile laminar flow model, the authors demonstrated that the relative Doppler bandwidth invariance theorem did not hold during flow acceleration and deceleration. In addition, a positive skewness of the Doppler spectra was observed during acceleration while a negative skewness was measured during the deceleration of blood. The effect of the window duration used in the Fourier spectral computation, on nonstationary broadening, is characterized.

The effects of hematocrit, shear rate, and turbulence on ultrasonic Doppler spectrum from blood

Previous studies of ultrasonic scattering properties of blood using a pulse-echo experimental arrangement show that ultrasonic backscatter from blood is influenced by a number of factors including hematocrit, shear rate, and the nature of flow (J. Acoust. Soc. Amer., vol. 75, p. 1265, 1984 and J. Acoust. Soc. Amer., vol. 84, p. 1, 1988). Since the Doppler frequency spectrum from a Doppler flowmeter is derived from echoes backscattered by red blood cells in the flowing blood, it is also undoubtedly a function of these parameters. The effects of these parameters on Doppler spectrum from blood have been investigated using a pulsed Doppler flowmeter. The results agree well with those obtained in previous studies. One important conclusion of this study is that the assumption that the Doppler spectral power density at a frequency in Doppler spectrum is linearly proportional to the number of red cells flowing at that velocity used in many theoretical models developed to explain the Doppler phenomenon may be erroneous. An alternative is proposed. It is shown that conclusions derived from these theoretical models would remain valid by making this assumption.

Ultrasonic backscatter from flowing whole blood. II: Dependence on frequency and fibrinogen concentration

Earlier studies showed that ultrasonic backscatter from erythrocytes suspended in saline is a function of hematocrit and frequency and that it can be affected by flow disturbance. The experimental data agree well with the theories. Recently, studies have been extended to flowing whole blood. The results indicated that ultrasonic backscatter from flowing whole blood differs from that from saline suspensions of erythrocytes in that it is shear-rate dependent and species dependent. In the present article, data on the dependence of ultrasonic backscatter from flowing whole blood on frequency and on fibrinogen concentration are reported. It was found that ultrasonic backscatter from flowing whole blood also depends on fibrinogen concentration when red blood cell (RBC) aggregation exists. Moreover, when the blood is under conditions that favor RBC aggregation such as low shear rates, high fibrinogen concentration, or high hematocrits, Rayleigh scattering apparently is no longer sufficient to describe its scattering behavior.

Ultrasonic backscatter from flowing whole blood. I: Dependence on shear rate and hematocrit

Previous results show that ultrasonic backscatter from red blood cells (RBCs) suspended in saline is a function of hematocrit and frequency and that it can be affected by flow disturbance. The experimental data agree well with the theories. In the present article, results on ultrasonic backscatter from flowing whole blood are reported. Studies have been conducted on porcine, bovine, and human blood. Ultrasonic backscatter of flowing whole blood differs from that of RBC suspensions in that it is shear-rate dependent, which means that it is a function of spatial position of the blood in the flow conduit. Moreover, the results indicate that it is also species dependent. This behavior can be readily understood when red cell aggregation is considered.