This paper presents a method for measuring pressure changes in deep-tissue vessels using vector velocity ultrasound data. The large penetration depth is ensured by acquiring data using a low frequency phased array transducer. Vascular pressure changes are then calculated from 2-D angle-independent vector velocity fields using a model based on the Navier-Stokes equations. Experimental scans are performed on a fabricated flow phantom having a constriction of 36% at a depth of 100 mm. Scans are carried out using a phased array transducer connected to the experimental scanner, SARUS. 2-D fields of angle-independent vector velocities are acquired using directional synthetic aperture vector flow imaging. The obtained results are evaluated by comparison to a 3-D numerical simulation model with equivalent geometry as the designed phantom. The study showed pressure drops across the constricted phantom varying from -40 Pa to 15 Pa with a standard deviation of 32%, and a bias of 25% found relative to the peak simulated pressure drop. This preliminary study shows that pressure can be estimated non-invasively to a depth that enables cardiac scans, and thereby, the possibility of detecting the pressure drops across the mitral valve.
The aim of this study was prospectively to monitor the volume flow in patients with arteriovenous fistula (AVF) with the angle independent ultrasound technique Vector Flow Imaging (VFI). Volume flow values were compared with Ultrasound dilution technique (UDT). Hemodialysis patients need a well-functioning vascular access with as few complications as possible and preferred vascular access is an AVF. Dysfunction due to stenosis is a common complication, and regular monitoring of volume flow is recommended to preserve AVF patency. UDT is considered the gold standard for volume flow surveillance, but VFI has proven to be more precise, when performing single repeated instantaneous measurements. Three patients with AVF were monitored with UDT and VFI monthly for five months. A commercial ultrasound scanner with a 9 MHz linear array transducer with integrated VFI was used to obtain data. UDT values were obtained with Transonic HD03 Flow-QC Hemodialysis Monitor. Three independent measurements at each scan session were obtained with UDT and VFI each month. Average deviation of volume flow between UDT and VFI was 25.7 % (Cl: 16.7% to 34.7%) (<i>p</i>= 0.73). The standard deviation for all patients, calculated from the mean variance of each individual scan sessions, was 199.8 ml/min for UDT and 47.6 ml/min for VFI (<i>p</i> = 0.002). VFI volume flow values were not significantly different from the corresponding estimates obtained using UDT, and VFI measurements were more precise than UDT. The study indicates that VFI can be used for surveillance of volume flow.
A non-invasive method for estimating 2-D pressure gradients from ultrasound vector velocity data is presented. The method relies on in-plane vector velocity elds acquired using the Transverse Oscillation method. The pressure gradients are estimated by applying the Navier-Stokes equations for isotropic uids to the estimated velocity elds. The velocity elds were measured for a steady ow on a carotid bifurcation phantom (Shelley Medical, Canada) with a 70% constriction on the internal branch. Scanning was performed with a BK8670 linear transducer (BK Medical, Denmark) connected to a BK Medical 2202 UltraView Pro Focus scanner. The results are validated through nite element simulations of the carotid ow model where the geometry is determined from MR images. This proof of concept study was conducted at nine ultrasound frames per second. Estimated pressure gradients along the longitudinal direction of the constriction varied from 0 kPa/m to 10 kPa/m with a normalized bias of -9.1% for the axial component and -7.9% for the lateral component. The relative standard deviation of the estimator, given in reference to the peak gradient, was 28.4% in the axial direction and 64.5% in the lateral direction. A study made across the constriction was also conducted. This yielded magnitudes from 0 kPa/m to 7 kPa/m with a normalized bias of -5.7% and 13.9% for the axial and lateral component, respectively. The relative standard deviations of this study were 45.2% and 83.2% in the axial and lateral direction, respectively.
Vector velocity imaging using the Transverse Oscillation (TO) approach has recently been FDA approved for linear array transducers on a commercial platform. It can now be used clinically for studying the complex ow at e.g. bifurcations, valves, and the heart in real time. Several clinical examples from venous ow to rotational ow in the heart will be shown. The technique is also being further developed and adapted for convex and phased array probes, for spectral velocity estimation, pressure estimation, and for three dimensional velocity tensor imaging. It is shown how the methods are optimized using Field II simulations along with several examples of their performance.