Prognostic Value of Coronary Flow Reserve Obtained on Dobutamine Stress Echocardiography and its Correlation with Target Heart Rate / Valor Prognóstico da Reserva de Fluxo Coronariano Obtida Durante o Ecocardiograma sob Estresse com Dobutamina e sua Correlação com a Frequência Cardíaca Alvo

Abstract Background: Normal coronary flow velocity reserve (CFVR) (≥ 2) obtained in the left anterior descending coronary artery (LAD) from transthoracic echocardiography is associated with a good prognosis, but there is no study correlating CFVR with submaximal target heart rate (HR). Objective: To evaluate the prognostic value of CFVR obtained in the LAD of patients with preserved (>50%) left ventricular ejection fraction (LVEF) who completed a dobutamine stress echocardiography (DSE), considering target HR. Methods: Prospective study of patients with preserved LVEF and CFVR obtained in the LAD who completed DSE. In Group I (GI = 31), normal CFVR was obtained before achieving target HR, and, in Group II (GII = 28), after that. Group III (G III=24) reached target HR, but CFVR was abnormal. Death, acute coronary insufficiency, coronary intervention, coronary angiography without further intervention, and hospitalization were considered events. Results: In 28 ± 4 months, there were 18 (21.6%) events: 6% (2/31) in GI, 18% (5/28) in GII, and 46% (11/24) in GIII. There were 4 (4.8%) deaths, 6 (7.2%) coronary interventions and 8 (9.6%) coronary angiographies without further intervention. In event-free survival by regression analysis, GIII had more events than GI (p < 0.001) and GII (p < 0.045), with no difference between GI and GII (p = 0.160). After adjustment, the only difference was between GIII and GI (p = 0.012). Conclusion: In patients with preserved LVEF and who completed their DSE, normal CFVR obtained before achieving target HR was associated with better prognosis.

Resumo Fundamento: A reserva de velocidade de fluxo coronariano (RVFC) adequada (≥ 2) obtida na artéria descendente anterior (ADA) através do ecocardiograma transtorácico associa-se a bom prognóstico, mas não há estudo correlacionando-a com a frequência cardíaca (FC) alvo (submáxima). Objetivo: Avaliar o valor prognóstico da RVFC obtida na ADA de pacientes com fração de ejeção do ventrículo esquerdo (FEVE) preservada (>50%) e ecocardiograma sob estresse com dobutamina (EED) concluído, considerando a FC alvo submáxima. Métodos: studo prospectivo de pacientes com FEVE preservada e RVFC obtida na ADA durante EED concluído. No Grupo I (GI=31), a RVFC adequada foi obtida antes de se atingir a FC alvo, e no Grupo II (G II=28), após. O Grupo III (G III=24) atingiu a FC alvo, mas a RVFC foi inadequada. Foram considerados eventos: óbito, insuficiência coronariana aguda, intervenção coronariana, coronariografia sem intervenção subsequente e internamento hospitalar. Resultados: Em 28 ± 4 meses, ocorreram 18 (21,6%) eventos, sendo 6% (2/31) no GI, 18% (5/28) no GII e 46% (11/24) no GIII. Foram 4 (4,8%) óbitos, 6 (7,2%) intervenções coronarianas e 8 (9,6%) coronariografias sem intervenção subsequente. Na sobrevida livre de eventos pela análise de regressão, GIII apresentou mais eventos do que GI (p < 0,001) ou GII (p < 0,045), não havendo diferença entre GI e GII (p = 0,160). Após o ajustamento, foi mantida a diferença apenas entre GIII e GI (p = 0,012). Conclusão: Em pacientes com FEVE preservada e EED concluído, a RVFC adequada obtida antes da FC alvo associou-se ao melhor prognóstico.

Prognostic Value of Coronary Flow Reserve Obtained on Dobutamine Stress Echocardiography and its Correlation with Target Heart Rate.

BACKGROUND:: Normal coronary flow velocity reserve (CFVR) (≥ 2) obtained in the left anterior descending coronary artery (LAD) from transthoracic echocardiography is associated with a good prognosis, but there is no study correlating CFVR with submaximal target heart rate (HR). OBJECTIVE:: To evaluate the prognostic value of CFVR obtained in the LAD of patients with preserved (>50%) left ventricular ejection fraction (LVEF) who completed a dobutamine stress echocardiography (DSE), considering target HR. METHODS:: Prospective study of patients with preserved LVEF and CFVR obtained in the LAD who completed DSE. In Group I (GI = 31), normal CFVR was obtained before achieving target HR, and, in Group II (GII = 28), after that. Group III (G III=24) reached target HR, but CFVR was abnormal. Death, acute coronary insufficiency, coronary intervention, coronary angiography without further intervention, and hospitalization were considered events. RESULTS:: In 28 ± 4 months, there were 18 (21.6%) events: 6% (2/31) in GI, 18% (5/28) in GII, and 46% (11/24) in GIII. There were 4 (4.8%) deaths, 6 (7.2%) coronary interventions and 8 (9.6%) coronary angiographies without further intervention. In event-free survival by regression analysis, GIII had more events than GI (p < 0.001) and GII (p < 0.045), with no difference between GI and GII (p = 0.160). After adjustment, the only difference was between GIII and GI (p = 0.012). CONCLUSION:: In patients with preserved LVEF and who completed their DSE, normal CFVR obtained before achieving target HR was associated with better prognosis. FUNDAMENTO:: A reserva de velocidade de fluxo coronariano (RVFC) adequada (≥ 2) obtida na artéria descendente anterior (ADA) através do ecocardiograma transtorácico associa-se a bom prognóstico, mas não há estudo correlacionando-a com a frequência cardíaca (FC) alvo (submáxima). OBJETIVO:: Avaliar o valor prognóstico da RVFC obtida na ADA de pacientes com fração de ejeção do ventrículo esquerdo (FEVE) preservada (>50%) e ecocardiograma sob estresse com dobutamina (EED) concluído, considerando a FC alvo submáxima. MÉTODOS:: studo prospectivo de pacientes com FEVE preservada e RVFC obtida na ADA durante EED concluído. No Grupo I (GI=31), a RVFC adequada foi obtida antes de se atingir a FC alvo, e no Grupo II (G II=28), após. O Grupo III (G III=24) atingiu a FC alvo, mas a RVFC foi inadequada. Foram considerados eventos: óbito, insuficiência coronariana aguda, intervenção coronariana, coronariografia sem intervenção subsequente e internamento hospitalar. RESULTADOS:: Em 28 ± 4 meses, ocorreram 18 (21,6%) eventos, sendo 6% (2/31) no GI, 18% (5/28) no GII e 46% (11/24) no GIII. Foram 4 (4,8%) óbitos, 6 (7,2%) intervenções coronarianas e 8 (9,6%) coronariografias sem intervenção subsequente. Na sobrevida livre de eventos pela análise de regressão, GIII apresentou mais eventos do que GI (p < 0,001) ou GII (p < 0,045), não havendo diferença entre GI e GII (p = 0,160). Após o ajustamento, foi mantida a diferença apenas entre GIII e GI (p = 0,012). CONCLUSÃO:: Em pacientes com FEVE preservada e EED concluído, a RVFC adequada obtida antes da FC alvo associou-se ao melhor prognóstico.

2-D tracking Doppler: a new method to limit spectral broadening in pulsed wave Doppler.

Transit time broadening is a major limitation in pulsed wave (PW) Doppler, especially when the angle between the flow direction and the ultrasound beam is large. The associated loss in frequency resolution may give severe overestimation of blood velocities, and finer details in the spectral display are lost. By using plane wave transmissions and parallel receive beamforming, multiple PW Doppler signals can be acquired simultaneously in a 2-D region. This enables tracking of the moving blood scatterers over a longer spatial distance to limit transit time broadening. In this work, the new method was tested using in vitro ultrasound recordings from a flow phantom, and in vivo recordings from a human carotid artery. The resulting 2-D tracking Doppler spectra showed significantly reduced spectral broadening compared with Doppler spectra generated by Welch's method. The reduction in spectral broadening was 4-fold when the velocity was 0.82 m/s and the beam-to-flow angle was 62°. A signal model was derived and the expected Doppler power spectra were calculated, showing good agreement with experimental data. Improved spectral resolution was shown for beam-to-flow angles between 40° and 82°.

Fetal left modified myocardial performance index: technical refinements in obtaining pulsed-Doppler waveforms.

OBJECTIVE: To assess the influence of machine settings (wall motion filter (WMF), angle of insonation, Doppler aliasing) and phase of valve clicks on repeatability of measurement of the fetal left modified myocardial performance index (Mod-MPI). METHODS: Fetal left Mod-MPI was evaluated prospectively in 157 morphologically normal fetuses at 19-36 weeks' gestation. In a baseline cohort, a previously published technique and settings were used for measurement of Mod-MPI. In a second cohort, the influence of WMF, angle of insonation, Doppler aliasing and selection of the phase of the valve clicks on repeatability of measurement of Mod-MPI was assessed. RESULTS: The intraclass correlation coefficient (ICC) for measurement repeatability in the baseline cohort was 0.22. Increase in WMF to 300 Hz or 500 Hz was associated with an increase in ICC to 0.60 and 0.55, respectively. An angle of insonation of < 15° was associated with an increase in ICC to 0.79 and 0.78 at a WMF of 300 and 500 Hz, respectively. A WMF of 300 Hz, angle of insonation of < 15° and absence of aliasing was associated with an increase in ICC to 0.85 and 0.87 at the beginning and peak of the valve click, respectively. Mod-MPI ranged from 0.35 to 0.48. An increase in calculated MPI was associated with increasing WMF, selection of the beginning vs. peak of the valve clicks and increase in angle of insonation. The presence or absence of aliasing had no effect. CONCLUSIONS: Refinement of machine settings improves repeatability of Mod-MPI, as does selection of the peak of the valve click. We suggest a consensus be reached as to the precise measurement of MPI, but for the moment would suggest: WMF, 300 Hz; angle of insonation, < 15°; avoiding Doppler aliasing; and selection of valve click peak. Systematic variation in measurement of time intervals may be responsible for the widely varying published normal ranges for Mod-MPI.

Comparison of hemodynamic versus dyssynchrony assessment for interventricular delay optimization with echocardiography in cardiac resynchronization therapy.

BACKGROUND: Best practice for cardiac resynchronization therapy (CRT) device optimization is not established. This study compared Tissue Doppler Imaging (TDI) to study left ventricular (LV) synchrony and left ventricular outflow tract velocity-time integral (LVOT VTI) to assess hemodynamic performance. METHODS: LVOT VTI and LV synchrony were tested in 50 patients at three interventricular (VV) delays (LV preactivation at -30 ms, simultaneous biventricular pacing, and right ventricular preactivation at +30 ms), selecting the highest VTI and the greatest degree of superposition of the displacement curves, respectively, as the optimum VV delay. RESULTS: In 39 patients (81%), both techniques agreed (Kappa = 0.65, p < 0.0001) on the optimum VV delay. LV preactivation (VV - 30) was the interval most frequently chosen. CONCLUSIONS: Both TDI and LVOT VTI are useful CRT programming methods for VV optimization. The best hemodynamic response correlates with the best synchrony. In most patients, the optimum VV interval is LV preactivation.

Flow patterns in carotid bifurcation models using pulsed Doppler ultrasound: effect of concentric vs. eccentric stenosis on turbulence and recirculation.

Hemodynamics play a significant role in stroke risk, where thrombus formation may be accelerated in regions of slow or recirculating flow, high shear and increased turbulence. An in vitro investigation was performed with pulsed Doppler ultrasound (DUS) using the complete spectral data to investigate the three-dimensional (3-D) distribution of advanced parameters that may have potential for making a more specific in vivo diagnosis of carotid disease and stroke risk. The effect of stenosis symmetry and the potential of DUS spectral parameters for visualizing regions of recirculation or turbulence were explored. DUS was used to map pulsatile flow in four model geometries representing two different plaque symmetries (eccentricity) and two stenosis severities (mild, severe). Qualitative comparisons were made with flow patterns visualized using digital particle imaging. Color-encoded maps of DUS spectral parameters (mean velocity, spectral-broadening index and turbulence intensity) clearly distinguished regions of slow or recirculating flow and disturbed or turbulent flow. Distinctly different flow patterns resulted from stenoses of equal severity but different eccentricity. Noticeable differences were seen in both the size and location of recirculation zones and in the paths of high-velocity jets. Highly elevated levels of turbulence intensity were seen distal to severe stenosis. Results demonstrated the importance of plaque shape, which is typically not considered in standard diagnosis, in addition to stenosis severity.

Measurement of cardiac output in normal pregnancy by a non-invasive two-dimensional independent Doppler device.

AIMS: To compose a normogram regarding cardiac output during pregnancy measured with ultrasonic cardiac output monitor (USCOM), a non-expensive simple continuous wave Doppler device and to investigate if this machine could be useful for haemodynamic monitoring during pregnancy. METHODS: Cardiac output was measured in 172 pregnant women with a gestational age < 21 weeks (n = 59), 21-32 weeks (n = 48), and > 32 weeks' gestation (n = 48). Interobserver differences were determined by measuring 24 patients and comparing results between three different observers. RESULTS: A good signal could be obtained in 155 (90.2%) pregnant women. Haemodynamic profiles were in line with data published in the literature. In 9.8 % of cases it was difficult to get a good result. Interobserver variations between the research officer (CK) and two clinicians were good (r = 0.9359 and r = 0.9609). CONCLUSION: USCOM appears to be a reliable and fast method to measure cardiac output compared with existing highly complex ultrasounds machines used in cardiology. It is easy to learn, cheap and quite reproducible between different observers. Further research is required to define its place in the management of hypertensive complications during pregnancy.

To-and-fro pattern: an indication of flow competition or a sign of incompetent coronary anastomosis?

To-and-fro pattern in pulse Doppler wave form has been considered a sign of flow competition at the coronary anastomosis. However, this flow pattern is not sufficient to judge whether there is no construction errors in the anastomosis itself. We report a usefulness of the high-frequency ultralinear transducer when used with pulse Doppler because it allows the visualization of the shapes of the anastomosis and each vessel, quantification of the flow, and elucidation of flow characteristics. This transducer can be applied to the management of suspected flow competition because, with pulse Doppler waveforms of graft flow and color Doppler images, it allows the detection of the diastolic-dominant flow pattern, good anastomotic shape, and smooth flow in the graft and the target vessel after the native vessel is clamped.

Characterization of dual-electrode CMUTs: demonstration of improved receive performance and pulse echo operation with dynamic membrane shaping.

A 1-D dual-electrode CMUT array for intracardiac echocardiography (ICE) with a center frequency of 8 MHz has been designed, fabricated, and used to demonstrate the potential of dual-electrode CMUTs. Using a dual-electrode CMUT, 9 dB higher receive signal level is obtained over the 6 dB fractional bandwidth as compared with a conventional CMUT with an identical center electrode biased close to its collapse voltage. Because the same device shows a 7.4 dB increase in maximum pressure output, 16.4 dB overall improvement in transduction performance has been achieved as compared with conventional CMUT. A net peak output pressure of 1.6 MPa on the dual-electrode CMUT membrane with tone burst excitation at 12 MHz is also reported. The frequency response of the dual-electrode CMUT is similar to that of a conventional CMUT with the same membrane geometry with about 15% increase in the center frequency. Monostatic operation of dual-electrode CMUTs shows that the high performance of the transducer is applicable in typical pulse-echo imaging mode of operation. With dynamic shaping of the CMUT membrane to optimize the transmit-and-receive modes of operation separately during each pulse-echo cycle, dual-electrode CMUT is a highly competitive alternative to its piezoelectric counterparts.

In vivo cardiac imaging of adult zebrafish using high frequency ultrasound (45-75 MHz).

The zebrafish has emerged as an excellent genetic model organism for studies of cardiovascular development. Optical transparency and external development during embryogenesis allow for visual analysis in the early development. However, to understand the cardiovascular structures and functions beyond the early stage requires a high-resolution, real-time, noninvasive imaging alternative due to the opacity of adult zebrafish. In this research, we report the development of a high frequency ultrasonic system for adult zebrafish cardiac imaging, capable of 75 MHz B-mode imaging at a spatial resolution of 25 microm and 45 MHz pulsed-wave Doppler measurement. The system allows for real-time delineation of detailed cardiac structures, estimation of cardiac dimensions, as well as image-guided Doppler blood flow measurements. In vivo imaging studies showed the identification of the atrium, ventricle, bulbus arteriosus, atrioventricular valve and bulboventricular valve in real-time images, with cardiac measurement at various stages. Doppler waveforms acquired at the ventricle and the bulbus arteriosus demonstrated the utility of this system to study the zebrafish cardiovascular hemodynamics. This high frequency ultrasonic system offers a multitude of opportunities for cardiovascular researchers. In addition, the detection of E-flow and A-flow during the ventricular filling and the appearance of diastolic flow reversal at bulbus arteriosus suggested the functional similarity of zebrafish heart to that of higher vertebrates.

Detection of tissue harmonic motion induced by ultrasonic radiation force using pulse-echo ultrasound and Kalman filter.

A method using pulse echo ultrasound and the Kalman filter is developed for detecting submicron harmonic motion induced by ultrasonic radiation force. The method estimates the amplitude and phase of the motion at desired locations within a tissue region with high sensitivity. The harmonic motion generated by the ultrasound radiation force is expressed as extremely small oscillatory Doppler frequency shifts in the fast time (A-line) of ultrasound echoes, which are difficult to estimate. In slow time (repetitive ultrasound echoes) of the echoes, the motion also is presented as oscillatory phase shifts, from which the amplitude and phase of the harmonic motion can be estimated with the least mean squared error by Kalman filter. This technique can be used to estimate the traveling speed of a harmonic shear wave by tracking its phase changes during propagation. The shear wave propagation speed can be used to solve for the elasticity and viscosity of tissue as reported in our earlier study. Validation and in vitro experiments indicate that the method provides excellent estimations for very small (submicron) harmonic vibrations and has potential for noninvasive and quantitative stiffness measurements of tissues such as artery.

Potential use of isovolumic contraction velocity in assessment of left ventricular contractility in man: A simultaneous pulsed Doppler tissue imaging and cardiac catheterization study.

AIMS: Echocardiographic techniques have so far provided suboptimal estimates of myocardial contractility in humans. Longitudinal myocardial motion during the isovolumic contraction (IVC) phase, measured by colour tissue Doppler imaging (TDI), has recently been shown in experimental animal models to reflect the state of myocardial contractility. The aim of the present study was to investigate the relationship between left ventricular (LV) isovolumic contraction velocities (IVCv) using pulsed Doppler tissue imaging (DTI) and global LV contractility as measured during cardiac catheterization. METHODS AND RESULTS: Cardiac catheterization and pulsed DTI were simultaneously performed in 16 consecutive patients (13 males, mean age 55+/-10years) with a variety of cardiac diseases. Relationships between the peak positive IVCv as measured at basal levels of the lateral, septal, anterior and posterior walls and the first derivative of LV pressure (+dP/dt(max)), were investigated. Peak IVCv measurements were obtainable in 81-100% of the four LV wall segments. Statistically significant linear relationships were found between IVCv and +dP/dt(max) at the lateral (r=0.58, P<0.05), septal (r=0.66, P<0.01), anterior (r=0.73, P<0.01) and posterior (r=0.81, P<0.001) segments of the LV. CONCLUSION: IVCv of the basal four LV walls correlates strongly with peak +dP/dt. IVCv is a readily obtainable non-invasive parameter, which correlates with the classical invasive measurement of global LV contractility. It appears likely that there are regional differences in wall motion when DTI is used to determine state of LV contractility.

Left ventricular diastolic function during normal pregnancy: assessment by spectral tissue Doppler imaging.

OBJECTIVE: Tissue Doppler imaging (TDI) is an echocardiographic technique for assessing the diastolic function that is relatively independent of preload. Since loading conditions change significantly during pregnancy, a load-independent technique will give a more accurate assessment of diastolic function in pregnant women. The aim of this study was to evaluate maternal diastolic function using tissue Doppler imaging. METHODS: This was a prospective observational study on 35 healthy pregnant women. M-mode, transmitral inflow (peak transmitral flow velocities during early diastole (E wave) and atrial contraction (A wave)) and TDI studies (peak myocardial velocities during early diastole (Em wave), during atrial contraction (Am wave) and peak systole in ejection phase (Sm)) were performed in each trimester and postpartum. The differences in variables between trimesters were analyzed. RESULTS: The peak transmitral inflow velocity during early diastole (E wave) was significantly decreased during the third trimester and postpartum. The peak flow velocity during atrial contraction (A wave) was increased in the second trimester, but decreased again in the third trimester and postpartum period. As a result, the E/A ratio progressively reduced as pregnancy advanced. TDI showed that peak myocardial velocities during early diastole (Em) tended to increase during the second trimester, and then decreased significantly in the third trimester or postpartum period. The peak myocardial velocities during atrial contraction (Am) increased significantly with advancing gestational age. As a consequence, both Em/Am and E/Em ratios decreased significantly throughout pregnancy. CONCLUSIONS: This study demonstrates the changes in myocardial relaxation velocity throughout pregnancy. Because of its advantage of being relatively load-independent, TDI may be a useful non-invasive technique for monitoring maternal cardiac function in high-risk pregnancies to detect the early signs of cardiac failure and to prevent further deterioration with prompt interventions.

Pulsed Doppler signal processing for use in mice: applications.

We have developed a high-frequency, high-resolution Doppler spectrum analyzer (DSPW) and compared its performance against an adapted clinical Medasonics spectrum analyzer (MSA) and a zero-crossing interval histogram (ZCIH) used previously by us to evaluate cardiovascular physiology in mice. The aortic velocity (means +/- SE: 92.7 +/- 2.5 versus 82.2 +/- 1.8 cm/s) and aortic acceleration (8194 +/- 319 versus 5178 +/- 191 cm/s2) determined by the DSPW were significantly higher compared to those by the MSA. Aortic ejection time was shorter (48.3 +/- 0.9 versus 64.6 +/- 1.8 ms) and the isovolumic relaxation was longer (17.6 +/- 0.6 versus 13.5 +/- 0.6 ms) when determined by the DSPW because it generates shorter temporal widths in the velocity spectra when compared to the MSA. These data indicate that the performance of the DSPW in evaluating cardiovascular physiology was better than that of the MSA. There were no significant differences between the aortic pulse wave velocity determined by using the ZCIH (391 +/- 16 cm/s) and the DSPW (394 +/- 20 cm/s). Besides monitoring cardiac function, we have used the DSPW for studying peripheral vascular physiology in normal, transgenic, and surgical models of mice. Several applications such as the detection of high stenotic jet velocities (> 4 m/s), vortex shedding frequencies (250 Hz), and subtle changes in wave shapes in peripheral vessels which could not obtained with clinical Doppler systems are now made possible with the DSPW.

Pulsed Doppler signal processing for use in mice: design and evaluation.

We have developed and evaluated a high-frequency, real-time pulsed Doppler and physiological signal acquisition and analysis system specifically for use in mice. The system was designed to provide sampling rates up to 125 kilosamples/s (ksps) with software controlled data acquisition and analysis in real-time. Complex fast Fourier transforms are performed every 0.1 ms (or longer up to 10 ms) to provide 0.1-ms time resolution and using 64-1024 sample segments of the Doppler audio signals resulting in frequency resolution ranging from 122-1953 Hz. The system was evaluated by its response to frequency swept signals with slopes (accelerations) and magnitudes (velocities) comparable to actual blood velocity signals in mice. Signals up to a maximum frequency of 125 kHz and a maximum acceleration of 20 MHz/s were processed and displayed. This corresponds to a maximum velocity of 480 (960) cm/s and a maximum acceleration of 750 (1500) m/s2 when Doppler shifts are measured with a 20- (10-) MHz probe, thereby allowing us to measure high stenotic jet velocities. The directional transitions of the spectrogram across zero frequency and across Nyquist frequency (sampling rate/2) were smooth with no discernible artifacts. Signals with period as low as 2 ms were processed and displayed at sweep speed that is ten times that in clinical Doppler systems, so that measurements of small temporal events can be made with precision. Thus, the new system can measure higher blood velocities with higher spatial and temporal resolution than is possible using clinical Doppler systems adapted for use in mice.

Coherent-array imaging using phased subarrays. Part I: basic principles.

The front-end hardware complexity of a coherent array imaging system scales with the number of active array elements that are simultaneously used for transmission or reception of signals. Different imaging methods use different numbers of active channels and data collection strategies. Conventional full phased array (FPA) imaging produces the best image quality using all elements for both transmission and reception, and it has high front-end hardware complexity. In contrast, classical synthetic aperture (CSA) imaging only transmits on and receives from a single element at a time, minimizing the hardware complexity but achieving poor image quality. We propose a new coherent array imaging method--phased subarray (PSA) imaging--that performs partial transmit and receive beam-forming using a subset of adjacent elements at each firing step. This method reduces the number of active channels to the number of subarray elements; these channels are multiplexed across the full array and a reduced number of beams are acquired from each subarray. The low-resolution subarray images are laterally upsampled, interpolated, weighted, and coherently summed to form the final high-resolution PSA image. The PSA imaging reduces the complexity of the front-end hardware while achieving image quality approaching that of FPA imaging.

Coherent array imaging using phased subarrays. Part II: simulations and experimental results.

The basic principles and theory of phased subarray (PSA) imaging imaging provides the flexibility of reducing the number of front-end hardware channels between that of classical synthetic aperture (CSA) imaging--which uses only one element per firing event--and full-phased array (FPA) imaging-which uses all elements for each firing. The performance of PSA generally ranges between that obtained by CSA and FPA using the same array, and depends on the amount of hardware complexity reduction. For the work described in this paper, we performed FPA, CSA, and PSA imaging of a resolution phantom using both simulated and experimental data from a 3-MHz, 3.2-cm, 128-element capacitive micromachined ultrasound transducer (CMUT) array. The simulated system point responses in the spatial and frequency domains are presented as a means of studying the effects of signal bandwidth, reconstruction filter size, and subsampling rate on the PSA system performance. The PSA and FPA sector-scanned images were reconstructed using the wideband experimental data with 80% fractional bandwidth, with seven 32-element subarrays used for PSA imaging. The measurements on the experimental sector images indicate that, at the transmit focal zone, the PSA method provides a 10% improvement in the 6-dB lateral resolution, and the axial point resolution of PSA imaging is identical to that of FPA imaging. The signal-to-noise ratio (SNR) of PSA image was 58.3 dB, 4.9 dB below that of the FPA image, and the contrast-to-noise ratio (CNR) is reduced by 10%. The simulated and experimental test results presented in this paper validate theoretical expectations and illustrate the flexibility of PSA imaging as a way to exchange SNR and frame rate for simplified front-end hardware.