RESUMO
In Doppler ultrasound, transit-time broadening arises from the finite scatterer transit time through the sample volume. As a unifying description of this broadening mechanism, a generalized amplitude modulation signal model was developed to collectively account for the transit-time effects of the ultrasound beam geometry and the range gate characteristics. Simulations based on a pulsed linear-array system also were performed to study the broadening extent for different scatterer flow lines. With our signal model and simulation results, some generalized insights were obtained on the characteristics of transit-time broadening. First, as consistent with previous findings, we found that, for scatterers passing though the center of the sample volume, the broadening extent mainly depends on beam-forming characteristics at higher beam-flow angles, but it is more dependent on range gate parameters at smaller angles. Second, for the central flow line, a transition angle exists in which a significant change occurs in the governing parameters of transit-time broadening. Third, for the general case in which scatterers undertake an off-central path through the sample volume, the broadening extent depends on both the beam geometry and the range gate. Bandwidth skewing and further spectral broadening also can be seen for these off-central flow lines.
Assuntos
Artérias/diagnóstico por imagem , Artérias/fisiologia , Artefatos , Velocidade do Fluxo Sanguíneo/fisiologia , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Modelos Cardiovasculares , Ultrassonografia Doppler de Pulso/métodos , Simulação por Computador , Humanos , Reprodutibilidade dos Testes , Espalhamento de Radiação , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: The study was conducted to assess the error and variability that results from human factors in Doppler peak velocity measurement. The positioning of the Doppler sample volume in the vessel, adjustment of the Doppler gain and angle, and choice of waveform display size were investigated. We hypothesized that even experienced vascular technologists in a laboratory accredited by the Intersocietal Commission for Accreditation of Vascular Laboratories make significant errors and have significant variability in the subjective adjustments made during measurements. METHODS: Problems of patient variability were avoided by having the four technologists measure peak velocities from an in vitro pulsatile flow model with unstenosed and 61% stenosed tubes. To evaluate inaccurate angle and sample volume positioning, a probe holder was used in some of the experiments to fix the Doppler angle at 60 degrees. The effect of Doppler gain was studied at three settings--low, ideal, and saturated gains--that were standardized from the ideal level chosen by consensus amongst the technologists. Two waveform display sizes were also investigated. Peak velocity measurement was assessed by comparison with true peak velocities. For each variable studied, average peak velocities were calculated from the 10 measurements made by each technologist and used to find the percent error from the true value, and the coefficient of variation was used to measure the variability. RESULTS: Doppler angle, sample volume placement, and the Doppler gain were the most significant sources of error and variability. Inaccurate angle and placement increased the variability in measurements from 1% to 2% (range) to 4% to 6% for the straight tube and from 1% to 2% to 3% to 9% for the 61% stenosis. The peak velocity error was increased from 9% to 13% to 7% to 28% for the stenosis. Both measurement error and variability were strongly dependent on the Doppler gain level. At low gain, the error was approximately 10% less than the true value and at saturated gain, 20% greater. The display size only affected measurements from the stenosed tube, increasing the error from 9% to 13% to 15% to 24%. CONCLUSIONS: Major factors affecting Doppler peak velocity measurement error and variability were identified. Inaccurate angle and sample volume placement increased the variability. The presence of a stenosis was found to increase the measurement errors. The error was found to depend on the Doppler gain setting, with greater variability at low and saturated gains and on the display size with a stenosis. CLINICAL RELEVANCE: Doppler ultrasound peak velocity measurements are widely used for the diagnostic assessment of the severity of arterial stenoses. However, it is known that these measurements are often in error. We have identified subjective human factors introduced by the technologist and assessed their contribution to peak velocity measurement error and variability. It is to be hoped that by understanding this, improvements in the machine design and measurement methods can be made that will result in improved measurement accuracy and reproducibility.
Assuntos
Artefatos , Velocidade do Fluxo Sanguíneo , Vasos Sanguíneos/diagnóstico por imagem , Ultrassonografia Doppler/estatística & dados numéricos , Humanos , Modelos Cardiovasculares , Variações Dependentes do ObservadorRESUMO
Experimental and computer simulation methods have been used to investigate the significance of beam steering as a potential source of error in pulsed-wave flow velocity estimation. By simulating a typical linear-array transducer system as used for spectral flow estimation, it is shown that beam steering can cause an angle offset resulting in a change in the effective beam-flow angle. This offset primarily depends on the F-number and the nominal steering angle. For example, at an F-number of 3 and a beam-flow angle of 70 degrees , the velocity error changed from -5% to + 5% when the steering angle changed from -20 degrees to + 20 degrees . Much higher errors can occur at higher beam-flow angles, with smaller F-numbers and greater steering. Our experimental study used a clinical ultrasound system, a tissue-mimicking phantom and a pulsatile waveform to determine peak flow velocity errors for various steering and beam-flow angles. These errors were found to be consistent with our simulation results.
Assuntos
Ultrassonografia Doppler de Pulso/métodos , Velocidade do Fluxo Sanguíneo , Simulação por Computador , Desenho de Equipamento , Humanos , Modelos Biológicos , Imagens de Fantasmas , Fluxo Pulsátil , Transdutores , UltrassomRESUMO
Various definitions of the sample volume (SV) shape have been proposed, but they are mostly based on transducers with axisymmetrical geometry. We have defined the SV as that spatial region in which scatterers contribute a component to the total gated received-signal energy above a defined threshold. This definition is consistent with modern pulsed transducer arrays and accounts for the need to impose a signal/noise threshold. Based on this definition, SVs for a typical linear phased-array transducer were simulated using custom-designed software. The effects of different transmit pulses, receive gates, apertures, SV depths and lateral foci were studied using a one-dimensional (1-D) beam-forming array, with a fixed lens in the elevation direction. Based on a simplified method of analysis, the features of the beam-steered SV are qualitatively similar to those of the nonsteered SV, when compared at the same beam-flow angle. These studies have helped provide a clearer understanding of the manner in which the SV energy distribution is affected by various parameters. The results can have potentially significant implications in the use of ultrasound (US) for blood velocity estimation, specifically with respect to locating the SV within the blood vessel and the origin of the velocity spectrum.