Longitudinal Quantitative Ultrasonic Analysis of Patellar Tendon in a Collegiate Athlete After Bilateral Debridement: A Case Report.

CONTEXT: A National Collegiate Athletic Association Division I female basketball athlete (age = 20 years, height = 190.5 cm, mass = 87 kg) had chronic patellar tendinopathy. INTERVENTION(S): After undergoing unsuccessful conservative treatments, the athlete underwent bilateral open patellar debridement surgery. Pain and dysfunction were assessed via the Victorian Institute of Sport-P (VISA-P) score with concurrently collected B-mode ultrasound images of the patellar tendon throughout a 12-month rehabilitation. RESULTS: Peak spatial frequency radius (PSFR), a quantitative ultrasound measure previously shown to be correlated with collagen organization, was compared with changes in VISA-P scores. Overall increases in PSFR values across 0°, 30°, 60°, and 90° of knee flexion were observed throughout recovery. Despite increased PSFR values and returning to sport, the athlete reported substantial pain. CONCLUSIONS: In this level 3 exploration case report, we provide novel insight into ultrasonically measured structural changes of the patellar tendon after surgery and during rehabilitation of an athlete with chronic tendinopathy. Perceived pain measurements were not necessarily related to structural adaptations.

Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow.

Functional transcranial Doppler ultrasound (fTCD) is the use of transcranial Doppler ultrasound (TCD) to study neural activation occurring during stimuli such as physical movement, activation of tactile sensors in the skin, and viewing images. Neural activation is inferred from an increase in the cerebral blood flow velocity (CBFV) supplying the region of the brain involved in processing sensory input. For example, viewing bright light causes increased neural activity in the occipital lobe of the cerebral cortex, leading to increased blood flow in the posterior cerebral artery, which supplies the occipital lobe. In fTCD, changes in CBFV are used to estimate changes in cerebral blood flow (CBF). With its high temporal resolution measurement of blood flow velocities in the major cerebral arteries, fTCD complements other established functional imaging techniques. The goal of this Methods paper is to give step-by-step instructions for using fTCD to perform a functional imaging experiment. First, the basic steps for identifying the middle cerebral artery (MCA) and optimizing the signal will be described. Next, placement of a fixation device for holding the TCD probe in place during the experiment will be described. Finally, the breath-holding experiment, which is a specific example of a functional imaging experiment using fTCD, will be demonstrated.

Most High-Intensity Transient Signals Are Not Associated With Specific Surgical Maneuvers.

BACKGROUND: Mortality after congenital heart defect surgery has dropped dramatically in the last few decades. Current research on long-term outcomes has focused on preventing secondary neurological sequelae, for which embolic burden is suspected. In children, little is known of the correlation between specific surgical maneuvers and embolic burden. Transcranial Doppler ultrasound is highly useful for detecting emboli but has not been widely used with infants and children. METHODS: Bilateral middle cerebral artery blood flow was continuously monitored from sternal incision to chest closure in 20 infants undergoing congenital heart defect repair or palliative surgery. Embolus counts for specific maneuvers were recorded using widely accepted criteria for identifying emboli via high-intensity transient signals (HITS). RESULTS: An average of only 13% of all HITS detected during an operation were correlated with any of the surgical maneuvers of interest. The highest mean number of HITS associated with a specific maneuver occurred during cross-clamp removal. Cross-clamp placement also had elevated HITS counts that significantly differed from other maneuvers. CONCLUSIONS: In this study of infants undergoing cardiac surgery with cardiopulmonary bypass, the great majority of HITS detected are not definitively associated with a specific subset of surgical maneuvers. Among the measured maneuvers, removal of the aortic cross-clamp was associated with the greatest occurrence of HITS. Future recommended research efforts include identifying and confirming other sources for emboli and longitudinal outcome studies to determine if limiting embolic burden affects long-term neurological outcomes.

Real-Time Cerebral Hemodynamic Response to Tactile Somatosensory Stimulation.

BACKGROUND AND PURPOSE: Recent studies in rodents suggest that somatosensory stimulation could provide neuroprotection during ischemic stroke by inducing plasticity in the cortex-vasculature relationship. While functional magnetic resonance imaging (fMRI) has shown that somatosensory stimulation increases cerebral blood flow (CBF) over several seconds, subsecond changes in CBF in the basal cerebral arteries have rarely been studied due to temporal resolution limitations. This study characterized hemodynamic changes in the middle cerebral arteries (MCAs) during somatosensory stimulation with high temporal resolution (100 samples/s) using functional transcranial Doppler ultrasound (fTCD). METHODS: Pneumotactile somatosensory stimulation, consisting of punctate pressure pulses traversing the glabrous skin of the hand at 25 cm/s, was used to induce CBF velocity (CBFV) response curves. Changes in CBFV were measured in the bilateral MCAs using fTCD. All 12 subjects underwent three consecutive trials consisting of 20 seconds of stimulation followed by 5 minutes of rest. RESULTS: Sharp, bilateral increases in CBFV of about 20% (left MCA = 20.5%, right MCA = 18.8%) and sharp decreases in pulsatility index of about 8% were observed during stimulation. Left lateralization of up to 3.9% was also observed. The magnitude of the initial increase in CBFV showed significant adaptation between subsequent trials. CONCLUSIONS: Pneumotactile somatosensory stimulation is a potent stimulus that can evoke large, rapid hemodynamic changes, with adaptation between successive stimulus applications. Due to its high temporal resolution, fTCD is useful for identifying quickly evolving hemodynamic responses, and for correlating changes in hemodynamic parameters such as pulsatility index (PI) and CBFV.

The Breath-Hold Acceleration Index: A New Method to Evaluate Cerebrovascular Reactivity using Transcranial Doppler.

BACKGROUND AND PURPOSE: Cerebrovascular reactivity (CR) is an ideal biomarker to detect cerebrovascular damage. CR can be quantified by measuring changes in cerebral blood flow velocity (CBFV) resulting from a CO2  vasodilatory stimulus, often using the breath-holding index (BHI). In this method, transcranial Doppler (TCD) ultrasound is used to measure CBFV changes in the middle cerebral artery (MCA) during a breath-hold maneuver. Despite its convenience, BHI has high variability. Changing body position may contribute to potential variability. It is important to determine if CR differs with body position. The aims of this study were, first, to propose an alternative, more robust index to evaluate CR using a breath-hold maneuver; second, investigate the effect of body position on CR measured with conventional (BHI) and a new proposed index. METHODS: Ten healthy young volunteers held their breath for 30 seconds on a tilt table. CR was calculated at five different angles using two indices: the conventional BHI, and the breath-hold acceleration index (BHAI), a new index obtained by linear regression of the most linear portion of the mean velocity change during the breath-hold maneuver. The regression represents acceleration (change in blood flow velocity per unit of time) sampled at each cardiac cycle. RESULTS: The mean coefficient of variation was 43.7% lower in BHAI in comparison with BHI. Neither index was statistically significant between body positions (P > .05). CONCLUSIONS: BHAI has less variability in comparison with the conventional standard BHI. Additionally, neither index showed statistical significance in CR based on change in body position.

Supraspinatus tendon micromorphology in individuals with subacromial pain syndrome.

STUDY DESIGN: Cross-sectional cohort. INTRODUCTION: Tendon collagen organization can be estimated by peak spatial frequency radius (PSFR) on ultrasound images. Characterizing PSFR can define the contribution of collagen disruption to shoulder symptoms. PURPOSE OF THE STUDY: The purpose of this was to characterize the (1) supraspinatus tendon PSFR in participants with subacromial pain syndrome (SPS) and healthy controls; (2) PSFR between participants grouped on a tendon visual quality score; and (3) relationship between PSFR with patient-reported pain, function, and shoulder strength. METHODS: Participants with SPS (n = 20) and age, sex, and arm-dominance-matched healthy controls (n = 20) completed strength testing in scaption and external rotation, and patient-reported pain, and functional outcomes. Supraspinatus tendon ultrasound images were acquired, and PSFR was calculated for a region of interest 15 mm medial to the supraspinatus footprint. PSFR was compared between groups using an independent t-test and an analysis of variance to compare between 3 groups for visually qualitatively rated tendon abnormalities. Relationships between PSFR with pain, function, and strength were assessed using Pearson correlation coefficient. RESULTS: Supraspinatus tendon PSFR was not different between groups (P = .190) or tendon qualitative ratings (P = .556). No relationship was found between PSFR and pain, functional loss, and strength (P > .05). CONCLUSIONS: Collagen disruption (PSFR) measured via ultrasound images of the supraspinatus tendon was not different between participants with SPS or in those with visually rated tendon defects. PSFR is not related to shoulder pain, function, and strength, suggesting that supraspinatus tendon collagen disorganization may not be a contributing factor to shoulder SPS. However, collagen disruption may not be isolated to a single region of interest. LEVEL OF EVIDENCE: 3b: case-control study.

Changes in tendon spatial frequency parameters with loading.

To examine and compare the loading related changes in micro-morphology of the patellar tendon. Fifteen healthy young males (age 19±3yrs, body mass 83±5kg) were utilised in a within subjects matched pairs design. B mode ultrasound images were taken in the sagittal plane of the patellar tendon at rest with the knee at 90° flexion. Repeat images were taken whilst the subjects were carrying out maximal voluntary isometric contractions. Spatial frequency parameters related to the tendon morphology were determined within regions of interest (ROI) from the B mode images at rest and during isometric contractions. A number of spatial parameters were observed to be significantly different between resting and contracted images (Peak spatial frequency radius (PSFR), axis ratio, spatial Q-factor, PSFR amplitude ratio, and the sum). These spatial frequency parameters were indicative of acute alterations in the tendon micro-morphology with loading. Acute loading modifies the micro-morphology of the tendon, as observed via spatial frequency analysis. Further research is warranted to explore its utility with regard to different loading induced micro-morphological alterations, as these could give valuable insight not only to aid strengthening of this tissue but also optimization of recovery from injury and treatment of conditions such as tendinopathies.

Cerebral hemodynamics during scene viewing: Hemispheric lateralization predicts temporal gaze behavior associated with distinct modes of visual processing.

Systematic patterns of eye movements during scene perception suggest a functional distinction between 2 viewing modes: an ambient mode (characterized by short fixations and large saccades) thought to reflect dorsal activity involved with spatial analysis, and a focal mode (characterized by long fixations and small saccades) thought to reflect ventral activity involved with object analysis. Little neuroscientific evidence exists supporting this claim. Here, functional transcranial Doppler ultrasound (fTCD) was used to investigate whether these modes show hemispheric specialization. Participants viewed scenes for 20 s under instructions to search or memorize. Overall, early viewing was right lateralized, whereas later viewing was left lateralized. This right-to-left shift interacted with viewing task (more pronounced in the memory task). Importantly, changes in lateralization correlated with changes in eye movements. This is the first demonstration of right hemisphere bias for eye movements servicing spatial analysis and left hemisphere bias for eye movements servicing object analysis. (PsycINFO Database Record

Functional Transcranial Doppler Ultrasound for Measurement of Hemispheric Lateralization During Visual Memory and Visual Search Cognitive Tasks.

Functional transcranial Doppler ultrasound (fTCD) is a noninvasive sensing modality that measures cerebral blood flow velocity (CBFV) with high temporal resolution. CBFV change is correlated to changes in cerebral oxygen uptake, enabling fTCD to measure brain activity and lateralization with high accuracy. However, few studies have examined the relationship of CBFV change during visual search and visual memory tasks. Here a protocol to compare lateralization between these two similar cognitive tasks using fTCD is demonstrated. Ten healthy volunteers (age 21±2 years) were shown visual scenes on a computer and performed visual search and visual memory tasks while CBFV in the bilateral middle cerebral arteries was monitored with fTCD. Each subject completed 40 trials, consisting of baseline (25 s), calibration (variable), instruction (2.5 s), and task (20 s) epochs. Lateralization was computed for each task by calculating the bilateral CBFV envelope percent change from baseline and subtracting the right side from the left side. The results showed significant lateralization ( ) of the visual memory and visual search tasks, with memory reaching lateralization of 1.6% and search reaching lateralization of 0.5%, suggesting that search is more right lateralized (and therefore may be related to "holistic" or global perception) and memory is more left lateralized (and therefore may be related to local perception). This method could be used to compare cerebral activity for any related cognitive tasks as long as the same stimulus is used in all tasks. The protocol is straightforward and the equipment is inexpensive, introducing a low-cost high temporal resolution technique to further study lateralization of the brain.

Ultrasound-Based Tendon Micromorphology Predicts Mechanical Characteristics of Degenerated Tendons.

The purpose of this study was to explore the relationship between tendon micro-morphology quantified from a sonogram and tendon mechanical characteristics measured in vivo. Nineteen adults (nine with unilateral Achilles tendinosis) participated. A commercial ultrasound scanner was used to capture longitudinal B-mode ultrasound images from the mid-portion of bilateral Achilles tendons and a custom image analysis program was used to analyze the spatial frequency content of manually defined regions of interest; in particular, the average peak spatial frequency of the regions of interest was acquired. In addition, a dynamometer and a motion analysis system indirectly measured the tendon mechanical (stiffness) and material (elastic modulus) properties. The peak spatial frequency correlated with tendon stiffness (r = 0.74, p = 0.02) and elastic modulus (r = 0.65, p = 0.05) in degenerated tendons, but not healthy tendons. This is the first study relating the mechanical characteristics of degenerated human Achilles tendon using a non-invasive micro-morphology analysis approach.

A new method for shear wave speed estimation in shear wave elastography.

Visualization of mechanical properties of tissue can aid in noninvasive pathology diagnosis. Shear wave elastography (SWE) measures the elastic properties of soft tissues by estimation of local shear wave propagation speed. In this paper, a new robust method for estimation of shear wave speed is introduced which has the potential for simplifying continuous filtering and real-time elasticity processing. Shear waves were generated by external mechanical excitation and imaged at a high frame rate. Three homogeneous phantoms of varying elastic moduli and one inclusion phantom were imaged. Waves propagating in separate directions were filtered and shear wave speed was estimated by inversion of the 1-D first-order wave equation. Final 2-D shear wave speed maps were constructed by weighted averaging of estimates from opposite traveling directions. Shear wave speed results for phantoms with gelatin concentrations of 5%, 7%, and 9% were 1.52 ± 0.10 m/s, 1.86 ± 0.10 m/s, and 2.37 ± 0.15 m/s, respectively, which were consistent with estimates computed from three other conventional methods, as well as compression tests done with a commercial texture analyzer. The method was shown to be able to reconstruct a 2-D speed map of an inclusion phantom with good image quality and variance comparable to conventional methods. Suggestions for further work are given.

Enabling real-time ultrasound imaging of soft tissue mechanical properties by simplification of the shear wave motion equation.

Ultrasound based shear wave elastography (SWE) is a technique used for non-invasive characterization and imaging of soft tissue mechanical properties. Robust estimation of shear wave propagation speed is essential for imaging of soft tissue mechanical properties. In this study we propose to estimate shear wave speed by inversion of the first-order wave equation following directional filtering. This approach relies on estimation of first-order derivatives which allows for accurate estimations using smaller smoothing filters than when estimating second-order derivatives. The performance was compared to three current methods used to estimate shear wave propagation speed: direct inversion of the wave equation (DIWE), time-to-peak (TTP) and cross-correlation (CC). The shear wave speed of three homogeneous phantoms of different elastic moduli (gelatin by weight of 5%, 7%, and 9%) were measured with each method. The proposed method was shown to produce shear speed estimates comparable to the conventional methods (standard deviation of measurements being 0.13 m/s, 0.05 m/s, and 0.12 m/s), but with simpler processing and usually less time (by a factor of 1, 13, and 20 for DIWE, CC, and TTP respectively). The proposed method was able to produce a 2-D speed estimate from a single direction of wave propagation in about four seconds using an off-the-shelf PC, showing the feasibility of performing real-time or near real-time elasticity imaging with dedicated hardware.

Achilles and patellar tendon morphology in dancers with and without tendon pain.

OBJECTIVES: To examine Achilles and patellar tendon morphology in dancers with and without tendon pain. METHODS: Fifty-three dancers with and without Achilles and/or patellar tendon pain participated. Eleven age-matched non-dancers served as controls. Longitudinal ultrasound images of the middle and distal Achilles and proximal and distal patellar tendons were acquired. To assess macromorphology, the thickness of the middle and distal Achilles and proximal and distal patellar tendons were measured. Micromorphology was analyzed by selecting 2 x 2-mm2 regions of interest in the tendons; spectral analysis using the fast Fourier transform was run for several kernels (2 x 2-mm2 subimages) within each image, and the peak spatial frequency (PSF) was extracted. A one-way ANOVA compared asymptomatic, symptomatic, and control tendon thickness and PSF. RESULTS: Macromorphology: There was no significant difference between asymptomatic and symptomatic dancers in middle or distal Achilles tendon thickness and distal patellar tendon thickness. Proximal patellar tendons in control subjects were thinner than those in asymptomatic (p=0.036) and symptomatic (p=0.003) dancers. Micromorphology: There was no significant difference in PSF between asymptomatic and symptomatic dancers and controls in the Achilles or patellar tendon. CONCLUSION: Increased proximal patellar tendon thickness without changes in tendon micromorphology suggests that tendon adaptations are more likely activity-related and less likely influenced by degeneration.

In vivo lateral blood flow velocity measurement using speckle size estimation.

In previous studies, we proposed blood measurement using speckle size estimation, which estimates the lateral component of blood flow within a single image frame based on the observation that the speckle pattern corresponding to blood reflectors (typically red blood cells) stretches (i.e., is "smeared") if blood flow is in the same direction as the electronically controlled transducer line selection in a 2-D image. In this observational study, the clinical viability of ultrasound blood flow velocity measurement using speckle size estimation was investigated and compared with that of conventional spectral Doppler of carotid artery blood flow data collected from human patients in vivo. Ten patients (six male, four female) were recruited. Right carotid artery blood flow data were collected in an interleaved fashion (alternating Doppler and B-mode A-lines) with an Antares Ultrasound Imaging System and transferred to a PC via the Axius Ultrasound Research Interface. The scanning velocity was 77 cm/s, and a 4-s interval of flow data were collected from each subject to cover three to five complete cardiac cycles. Conventional spectral Doppler data were collected simultaneously to compare with estimates made by speckle size estimation. The results indicate that the peak systolic velocities measured with the two methods are comparable (within ±10%) if the scan velocity is greater than or equal to the flow velocity. When scan velocity is slower than peak systolic velocity, the speckle stretch method asymptotes to the scan velocity. Thus, the speckle stretch method is able to accurately measure pure lateral flow, which conventional Doppler cannot do. In addition, an initial comparison of the speckle size estimation and color Doppler methods with respect to computational complexity and data acquisition time indicated potential time savings in blood flow velocity estimation using speckle size estimation. Further studies are needed for calculation of the speckle stretch method across a field of view and combination with an appropriate axial flow estimator.

Physical activity discrimination improvement using accelerometers and wireless sensor network localization - biomed 2013.

Automating documentation of physical activity data (e.g., duration and speed of walking or propelling a wheelchair) into the electronic medical record (EMR) offers promise for improving efficiency of documentation and understanding of best practices in the rehabilitation and home health settings. Commercially available devices which could be used to automate documentation of physical activities are either cumbersome to wear or lack the specificity required to differentiate activities. We have designed a novel system to differentiate and quantify physical activities, using inexpensive accelerometer-based biomechanical data technology and wireless sensor networks, a technology combination that has not been used in a rehabilitation setting to date. As a first step, a feasibility study was performed where 14 healthy young adults (mean age = 22.6 ± 2.5 years, mean height = 173 ± 10.0 cm, mean mass = 70.7 ± 11.3 kg) carried out eight different activities while wearing a biaxial accelerometer sensor. Activities were performed at each participant’s self-selected pace during a single testing session in a controlled environment. Linear discriminant analysis was performed by extracting spectral parameters from the subjects’ accelerometer patterns. It is shown that physical activity classification alone results in an average accuracy of 49.5%, but when combined with rule-based constraints using a wireless sensor network with localization capabilities in an in silico simulated room, accuracy improves to 99.3%. When fully implemented, our technology package is expected to improve goal setting, treatment interventions and patient outcomes by enhancing clinicians’ understanding of patients’ physical performance within a day and across the rehabilitation program.

Monitoring cerebral hemodynamics with transcranial Doppler ultrasound during cognitive and exercise testing in adults following unilateral stroke.

An observational study was performed as a preliminary investigation into the use of transcranial Doppler ultrasound (TCD) for recording cerebral hemodynamic changes during multiple tasks. TCD is a method of measuring cerebral blood flow (CBF) using ultrasound transducers in contact with the surface of the head. Using the maximum flow envelope of the Doppler spectrum returning from the middle cerebral artery (MCA), standard clinical flow indices can be calculated and displayed in real time providing information concerning perturbations in CBF and their potential cause. These indices as well as flow velocity measurements have been recognized as useful in measuring changes in responses to various stimulus that can be used to indicate cardiovascular health. For this study, the pulsatility index (PI) and resistivity index (RI) were chosen since they indicate composite changes indicative of vasoconstriction and vasodilatation which are normal hemodynamic responses under appropriate conditions. A total of eleven participants were recruited to take part in this study. Nine of these individuals had no known disability (Controls); two had experienced unilateral cerebrovascular accidents (Strokes) in the ipsilateral MCA distribution. Maximum velocity envelopes of the spectral Doppler data were recorded using a fixation device designed to stabilize two ultrasound probes (2 MHz) to sample the bilateral MCAs CBF. These measures were performed separately while the subject performed four activities: 1) rest, 2) cognitive challenge, 3) cardiovascular exercise, and 4) simultaneous exercise and cognitive challenge. Cardiovascular parameters were calculated from the data by extracting maximum (Vs) and minimum flow velocities (Vd), PI, RI, and time signatures for each cardiac cycle. The data for all participants shows significant changes in cardiovascular parameters between states of rest and exercise, as well as slight trends across time. Although the data are preliminary, they show the capability of using Doppler spectral examination of the bilateral MCAs in individuals with physical limitation performing cardiovascular exercise. The novelty of examining a population using dynamic exercise who before could not perform such exercise offers the opportunity to study the impact of exercise on global cerebral recovery in unilateral stroke with significant physical impairment.

Lateral blood flow velocity estimation based on ultrasound speckle size change with scan velocity.

Conventional (Doppler-based) blood flow velocity measurement methods using ultrasound are capable of resolving the axial component (i.e., that aligned with the ultrasound propagation direction) of the blood flow velocity vector. However, these methods are incapable of detecting blood flow in the direction normal to the ultrasound beam. In addition, these methods require repeated pulse-echo interrogation at the same spatial location. A new method has been introduced which estimates the lateral component of blood flow within a single image frame using the observation that the speckle pattern corresponding to blood reflectors (typically red blood cells) stretches (i.e., is smeared) if the blood is moving in the same direction as the electronically-controlled transducer line selection in a 2-D image. The situation is analogous to the observed distortion of a subject photographed with a moving camera. The results of previous research showed a linear relationship between the stretch factor (increase in lateral speckle size) and blood flow velocity. However, errors exist in the estimation when used to measure blood flow velocity. In this paper, the relationship between speckle size and blood flow velocity is investigated further with both simulated flow data and measurements from a blood flow phantom. It can be seen that: 1) when the blood flow velocity is much greater than the scan velocity (spatial rate of A-line acquisition), the velocity will be significantly underestimated because of speckle decorrelation caused by quick blood movement out of the ultrasound beam; 2) modeled flow gradients increase the average estimation error from a range between 1.4% and 4.4%, to a range between 4.4% and 6.8%; and 3) estimation performance in a blood flow phantom with both flow gradients and random motion of scatterers increases the average estimation error to between 6.1% and 7.8%. Initial attempts at a multiple-scan strategy for estimating flow by a least-squares model suggest the possibility of increased accuracy using multiple scan velocities.

Optimal thresholds of feature tracking for blood velocity and tissue motion estimation.

Feature tracking is an algorithm for estimating blood flow velocity and tissue motion using pulse-echo ultrasound. In contrast to cross-correlation speckle-tracking techniques, feature tracking identifies features at discrete locations and corresponds them from frame to frame. Prior studies have demonstrated that feature-tracking estimates exhibit lower variance than those obtained by the conventional autocorrelation method and require less computational complexity than either speckle tracking or autocorrelation. To date, not much attention has been paid to the process by which trackable features (normally local maxima) are selected from the set of all available features. In the selection process, it is desired to minimize flow estimate variance while providing sufficient spatial and temporal coverage of flow area. Flow studies were performed with a blood flow phantom, 3.5-MHz spherically focused transducer, and a pulser/receiver. Values were selected for the amplitude threshold (based on the RMS value) and width thresholds (based on the wavelength corresponding to transducer center frequency). The performance of this method using different threshold values was evaluated by the estimate standard deviation and number of features available to track. Results show that an optimal width threshold occurs at about 40 to 45% of the transmission wavelength, while a trade-off exists between amplitude thresholds and spatial flow field coverage. Both the standard deviation of estimated velocities and number of available features decrease with increasing threshold (either amplitude or width). This affords a user a method of determining optimal feature tracking thresholds depending on the specific flow application. Judicious selection of feature thresholds can decrease the estimate standard deviation by more than 25%.

Resolving the lateral component of blood flow velocity based on ultrasound speckle size change with scan direction and speed.

Conventional blood flow velocity measurement using ultrasound is capable of resolving the axial component (i.e., that aligned with the ultrasound propagation direction) of the blood flow velocity vector. However, these Doppler-based methods are incapable of detecting blood flow in the direction normal to the ultrasound beam. In addition, these methods require repeated pulse-echo interrogation at the same spatial location. In this paper, we introduce a method which estimates the lateral component of blood flow within a single image frame using the observation that the speckle pattern corresponding to the blood reflectors (typically red blood cells) stretches (i.e., is "smeared") if the blood is moving in the same direction as the electronically-controlled transducer line selection in a 2D image. The situation is analogous to the observed elongation of a subject photographed with a moving camera. Here, we develop a relationship between speckle size, scan speed, and blood flow velocity. Experiments were performed with a blood flow phantom and high-frequency transducer of a commercially available ultrasound machine. Data was captured through an interface allowing access to the raw beam formed data. Blood flow with velocities ranging from 15 to 40 cm/s were investigated in this paper. Results show that there is a linear relationship between the reciprocal of the stretch factor and blood flow velocity. Two scan speeds were used in our experiments. When the scan velocity is 64.8 cm/s, compared with the theoretical model, fitting results based on experimental data gave us a linear relationship with average flow estimation error of 1.74+/-1.48 cm/s. When the scan velocity is 37.4 cm/s, the average estimation error is 0.65+/-0.45 cm/s.