Colour ultrasound imaging of blood flow and tissue motion

Testing a new surfactant in a widely-used blood mimic for ultrasound flow imaging

Background

A blood-mimicking fluid developed by Ramnarine et al. has been widely used in flow phantoms for ultrasound flow imaging research, and it has also been cited by IEC 61685 as a reference for making blood-mimicking fluid.However, the surfactant material Synperonic N in this blood-mimicking fluid recipe is phased out from the European market due to environmental issues. The aim of this study is to test whether Synperonic N can be substituted by biodegradable Synperonic A7 in making blood-mimicking fluid for ultrasound flow imaging research.

Methods and materials

A flow phantom was fabricated to test the blood-mimicking fluid with Synperonic N and Synperonic A7 as surfactants separately. Doppler images and velocity data were collected using a clinical ultrasound scanner under constant and pulsatile flows; and images and measured velocities were compared.

Results

It was found that both blood mimics can provide exactly the same images under spectral Doppler ultrasound and colour Doppler ultrasound in terms of their image qualities. The maximum velocities under constant flow were measured by the spectral Doppler ultrasound as 0.4714 ± 0.001 m.s^-1 and 0.4644 ± 0.001 m.s^-1 for blood-mimicking fluid with Synperonic N and blood-mimicking fluid with Synperonic A7, respectively. Measured velocities using the two different blood-mimicking fluids were statistically different (p < 0.001), but this difference was less than 2%. The Synperonic A7 can be used as a substitute for Synperonic N as a surfactant material in making the blood-mimicking fluid for ultrasound flow imaging research.

Vector projectile imaging: time-resolved dynamic visualization of complex flow patterns

Achieving non-invasive, accurate and time-resolved imaging of vascular flow with spatiotemporal fluctuations is well acknowledged to be an ongoing challenge. In this article, we present a new ultrasound-based framework called vector projectile imaging (VPI) that can dynamically render complex flow patterns over an imaging view at millisecond time resolution. VPI is founded on three principles: (i) high-frame-rate broad-view data acquisition (based on steered plane wave firings); (ii) flow vector estimation derived from multi-angle Doppler analysis (coupled with data regularization and least-squares fitting); (iii) dynamic visualization of color-encoded vector projectiles (with flow speckles displayed as adjunct). Calibration results indicated that by using three transmit angles and three receive angles (-10°, 0°, +10° for both), VPI can consistently compute flow vectors in a multi-vessel phantom with three tubes positioned at different depths (1.5, 4, 6 cm), oriented at different angles (-10°, 0°, +10°) and of different sizes (dilated diameter: 2.2, 4.4 and 6.3 mm; steady flow rate: 2.5 mL/s). The practical merit of VPI was further illustrated through an anthropomorphic flow phantom investigation that considered both healthy and stenosed carotid bifurcation geometries. For the healthy bifurcation with 1.2-Hz carotid flow pulses, VPI was able to render multi-directional and spatiotemporally varying flow patterns (using a nominal frame rate of 416 fps or 2.4-ms time resolution). In the case of stenosed bifurcations (50% eccentric narrowing), VPI enabled dynamic visualization of flow jet and recirculation zones. These findings suggest that VPI holds promise as a new tool for complex flow analysis.

Correlation functions and power spectra of Doppler response signals in ultrasonic medical applications

Ultrasound Doppler methods are widely used in clinical practice as prospective investigational tool to study the vascular system and soft biological tissues. Meanwhile, the most general relationship between the power Doppler spectra, spectral characteristics of the scattering fluctuations and the probing ultrasound field parameters for some clinical implementations are still unexplored. Based upon the continuum model of scattering inhomogeneities, a set of the closed-form expressions for the correlation functions and the spectra of Doppler response of soft tissues and blood have been derived. The influence of the correlation among inhomogeneities and the diffusion processes on the Doppler power spectra formed by stationary flows have been examined. Computer simulations of Doppler spectra were performed for different values of correlation radius and diffusion coefficient. With simulation results the effects of the correlation among inhomogeneities and the diffusion processes on the spectral width and mean frequency are established and discussed in respect to turbulent flows. Closed-form expressions for correlation functions and Doppler spectra for the vibrational sonoelastography technique for visualizing malignant tumors in tissues have been derived. Based on the peculiarities of the obtained Doppler spectra, it is shown that the differentiation of soft tissues with respect to the amplitude value of constrained oscillations is feasible. The expressions were derived for the cases of non-stationary accelerated blood movement. It has been found that the frequency dependence reveals solely at a finite time of observation and depends on the initial phase of the accelerated movement.

Simulation and validation of arterial ultrasound imaging and blood flow

We reviewed the simulation and validation of arterial ultrasound imaging and blood flow assessment. The physical process of ultrasound imaging and measurement is complex, especially in disease. Simulation of physiological flow in a phantom with tissue equivalence of soft tissue, vessel wall and blood is now achievable. Outstanding issues are concerned with production of anatomical models, simulation of arterial disease, refinement of blood mimics to account for non-Newtonian behavior and validation of velocity measurements against an independent technique such as particle image velocimetry. String and belt phantoms offer simplicity of design, especially for evaluation of velocity estimators, and have a role as portable test objects. Electronic injection and vibrating test objects produce nonphysiologic Doppler signals, and their role is limited. Computational models of the ultrasound imaging and measurement process offer considerable flexibility in their ability to alter multiple parameters of both the propagation medium and ultrasound instrument. For these models, outstanding issues are concerned with the inclusion of different tissue types, multilayer arteries, inhomogeneous tissues and diseased tissues.

Noninvasive assessment of laryngeal phonation function using color Doppler ultrasound imaging

Color Doppler imaging (CDI) was used to identify the morphology of vocal folds (VF) and to quantify the tissue horizontal displacement velocity (HDV) in the vibrating portion of VF. Mucosal HDV that gives an estimate of the stiffness of the VF cover is very important clinically. The VF and its cover were shown to be very hypoechoic and not adequately visible in B-scan image. However, in this study, we found that the structure of the true VF, especially the mucosa and the superficial layer of the lamina propria, the so-called "cover," can be easily identified and evaluated using CDI. The mean VF displacement velocity was measured by decoding the pseudocolor codes of the ultrasound (US) image at the vibrating sites. The mucosal mean HDV obtained from 10 normal men of age 34 +/- 8 years phonating at their most comfortable pitch and intensity (98 +/- 12 Hz, 55-65 dB) was about 68 +/- 10 cm/s, which agreed reasonably with the literature. Therefore, the CDI could be used as a potential tool for assessing the phonation function in the larynx nonintrusively.

Developments in cardiovascular ultrasound. Part 2: Arterial applications

Many of the changes resulting from arterial disease can be measured, using Doppler ultrasound for measurement of blood velocity and B-scan imaging for measurement of tissue structure and composition. Wall thickness, the degree of arterial narrowing and plaque volume can be measured using B-scan imaging, and 3D ultrasound can be used to improve the accuracy of measurements of plaque volume and for improved visualisation of complex arterial geometries. Measurement of the dynamic properties of the arterial wall permits estimation of wall elasticity and plaque motion. From the Doppler signal, measurements of blood velocity are used to estimate the degree of arterial narrowing and volumetric flow, although measurement errors can be large. Wall shear stress can be estimated by measuring the velocity gradient at the vessel wall. The problems of inadequate spatial resolution and interference from overlying tissue are largely removed when intravascular systems are used, and these have superior capability in the assessment of arterial structure and tissue composition. However, measurement of quantities relating to blood flow is more difficult using the intravascular approach, as the indwelling cather disturbs the blood flow pattern, and currently, assessment of flow and vessel cross-section are not performed at the same site.

A flow model of cerebral aneurysms for use with power Doppler studies

It has recently been observed using power Doppler that cerebral aneurysms appear to change size through the cardiac cycle. The purpose of this study was to develop a pulsatile flow model of cerebral aneurysm expansion and to investigate whether the observations of pulsation could be confirmed using the model. The model consisted of a latex bubble glued onto the side of a latex tube. A computer controlled pump was used to generate pulsatile flow. The degree of bubble expansion was adjusted by the use of flow restrictor placed in the downstream section of the flow rig. Ultrasound images were acquired using an Acuson 128 XP/10V colour flow scanner. True expansion (maximum area/minimum area) was measured from the B-scan image using a 7 MHz probe. Three observers measured expansion of the simulated aneurysm from the power Doppler images using a 2 MHz probe. Expansion measured with the power Doppler decreased as the colour gain setting increased, and decreased as the persistence increased. The true expansion of 1.43 was comparable with the colour gain set optimally for a persistence value of 3. The model allows simple investigations of the relationship between true aneurysm expansion and that measured from the power Doppler images. Colour gain and persistence settings must be standardized in clinical studies.