Plane-wave transverse oscillation for high-frame-rate 2-D vector flow imaging

Dynamic Coronary Blood Flow Velocity and Wall Shear Stress Estimation Using Ultrasound in an Ex Vivo Porcine Heart

PURPOSE

Wall shear stress (WSS) is a critically important physical factor contributing to atherosclerosis. Mapping the spatial distribution of local, oscillatory WSS can identify important mechanisms underlying the progression of coronary artery disease.

METHODS

In this study, blood flow velocity and time-varying WSS were estimated in the left anterior descending (LAD) coronary artery of an ex vivo beating porcine heart using ultrasound with an 18 MHz linear array transducer aligned with the LAD in a forward-viewing orientation. A pulsatile heart loop with physiologically-accurate flow was created using a pulsatile pump. The coronary artery wall motion was compensated using a local block matching technique. Next, 2D and 3D velocity magnitude and WSS maps in the LAD coronary artery were estimated at different time points in the cardiac cycle using an ultrafast Doppler approach. The blood flow velocity estimated using the presented approach was compared with a commercially-available, calibrated single element blood flow velocity measurement system.

RESULTS

The resulting root mean square error (RMSE) of 2D velocity magnitude acquired from a high frequency, linear array transducer was less than 8% of the maximum velocity estimated by the commercial system.

CONCLUSION

When implemented in a forward-viewing intravascular ultrasound device, the presented approach will enable dynamic estimation of WSS, an indicator of plaque vulnerability in coronary arteries.

Transverse oscillation tensor velocity imaging using a row-column addressed array: Experimental validation

Tensor velocity imaging (TVI) performance with a row-column probe was assessed for constant flow in a straight vessel phantom and pulsatile flow in a carotid artery phantom. TVI, i.e., estimating the 3-D velocity vector as a function of time and spatial position, was performed using the transverse oscillation cross-correlation estimator, and the flow was acquired with a Vermon 128+128 row-column array probe connected to a Verasonics 256 research scanner. The emission sequence used 16 emissions per image, and a TVI volume rate of 234 Hz was obtained for a pulse repetition frequency (f_prf) of 15 kHz. The TVI was validated by comparing estimates of the flow rate through several cross-sections with the flow rate set by the pump. For the constant 8 mL/s flow in the straight vessel phantom with relative estimator bias (RB) and standards deviation (RSD) was found in the range of -2.18% to 0.55% and 4.58% to 2.48% in measurements performed with an f_prf of 15, 10, 8, and 5 kHz. The pulsatile flow in the carotid artery phantom the was set to an average flow rate of 2.44 mL/s, and the flow was acquired with an f_prf of 15, 10, and 8 kHz. The pulsatile flow was estimated from two measurement sites: one at a straight section of the artery and one at the bifurcation. In the straight section, the estimator predicted the average flow rate with an RB value ranging from -7.99% to 0.10% and an RSD value ranging from 10.76% to 6.97%. At the bifurcation, RB and RSD values were between -7.47% to 2.02% and 14.46% to 8.89%. This demonstrates that an RCA with 128 receive elements can accurately capture the flow rate through any cross-section at a high sampling rate.

Advanced Fourier migration for Plane-Wave vector flow imaging

Ultrafast ultrasound imaging modalities have been studied extensively in the ultrasound community. It breaks the compromise between the frame rate and the region of interest by imaging the whole medium with wide unfocused waves. Continuously available data allow monitoring fast transient dynamics at hundreds to thousands of frames per second. This feature enables a more accurate and robust velocity estimation in vector flow imaging (VFI). On the other hand, the huge amount of data and real-time processing demands are still challenging in VFI. A solution is to provide a more efficient beamforming approach with smaller computation complexity than the conventional time-domain beamformer like delay-and-sum (DAS). Fourier-domain beamformers are shown to be more computationally efficient and can provide equally good image quality as DAS. However, previous studies generally focus on B-mode imaging. In this study, we propose a new framework for VFI which is based on two advanced Fourier migration methods, namely, slant stack migration (SSM) and ultrasound Fourier slice beamform (UFSB). By carefully modifying the beamforming parameters, we successfully apply the cross-beam technique within the Fourier beamformers. The proposed Fourier-based VFI is validated in simulation studies, in vitro, and in vivo experiments. The velocity estimation is evaluated via bias and standard deviation and the results are compared with conventional time-domain VFI using the DAS beamformer. In the simulation, the bias is 6.4%, -6.2%, and 5.7%, and the standard deviation is 4.3%, 2.4%, and 3.9% for DAS, UFSB, and SSM, respectively. In vitro studies reveal a bias of 4.5%, -5.3%, and 4.3% and a standard deviation of 3.5%, 1.3%, and 1.6% from DAS, UFSB, and SSM, respectively. The in vivo imaging of the basilic vein and femoral bifurcation also generate similar results using all three methods. With the proposed Fourier beamformers, the computation time can be shortened by up to 9 times and 14 times using UFSB and SSM.

Adaptive Wall Shear Stress Imaging in Phantoms, Simulations and In Vivo

WSS measurement is challenging since it requires sensitive flow measurements at a distance close to the wall. The aim of this study is to develop an ultrasound imaging technique which combines vector flow imaging with an unsupervised data clustering approach that automatically detects the region close to the wall with optimally linear flow profile, to provide direct and robust WSS estimation. The proposed technique was evaluated in phantoms, mimicking normal and atherosclerotic vessels, and spatially registered Fluid Structure Interaction (FSI) simulations. A relative error of 6.7% and 19.8% was obtained for peak systolic (WSSPS) and end diastolic (WSSED) WSS in the straight phantom, while in the stenotic phantom, a good similarity was found between measured and simulated WSS distribution, with a correlation coefficient, R, of 0.89 and 0.85 for WSSPS and WSSED, respectively. Moreover, the feasibility of the technique to detect pre-clinical atherosclerosis was tested in an atherosclerotic swine model. Six swines were fed atherogenic diet, while their left carotid artery was ligated in order to disturb flow patterns. Ligated arterial segments that were exposed to low WSSPS and WSS characterized by high frequency oscillations at baseline, developed either moderately or highly stenotic plaques (p < 0.05). Finally, feasibility of the technique was demonstrated in normal and atherosclerotic human subjects. Atherosclerotic carotid arteries with low stenosis had lower WSSPS as compared to control subjects (p < 0.01), while in one subject with high stenosis, elevated WSS was found on an arterial segment, which coincided with plaque rupture site, as determined through histological examination.

Two-Dimensional Wavenumber Analysis Implemented in Ultrasonic Vector Doppler Method with Focused Transmit Beams

The multi-angle Doppler method was introduced for the estimation of velocity vectors by measuring axial velocities from multiple directions. We have recently reported that the autocorrelation-based velocity vector estimation could be ameliorated significantly by estimating the wavenumbers in two dimensions. Since two-dimensional wavenumber estimation requires a snapshot of an ultrasonic field, the method was first implemented in plane wave imaging. Although plane wave imaging is predominantly useful for examining blood flows at an extremely high temporal resolution, it was reported that the contrast in a B-mode image obtained with a few plane wave emissions was lower than that obtained with focused beams. In this study, the two-dimensional wavenumber analysis was first implemented in a framework with focused transmit beams. The simulations showed that the proposed method achieved an accuracy in velocity estimation comparable to that of the method with plane wave imaging. Furthermore, the performances of the methods implemented in focused beam and plane wave imaging were compared by measuring human common carotid arteries in vivo. Image contrasts were analyzed in normal and clutter-filtered B-mode images. The method with focused beam imaging achieved a better contrast in normal B-mode imaging, and similar velocity magnitudes and angles were obtained by both the methods with focused beam and plane wave imaging. In contrast, the method with plane wave imaging gave a better contrast in a clutter-filtered B-mode image and smaller variances in velocity magnitudes than those with focused beams.

Minimizing Image Quality Loss After Channel Count Reduction for Plane Wave Ultrasound via Deep Learning Inference

High-frame-rate ultrasound imaging uses unfocused transmissions to insonify an entire imaging view for each transmit event, thereby enabling frame rates over 1000 frames per second (fps). At these high frame rates, it is naturally challenging to realize real-time transfer of channel-domain raw data from the transducer to the system back end. Our work seeks to halve the total data transfer rate by uniformly decimating the receive channel count by 50% and, in turn, doubling the array pitch. We show that despite the reduced channel count and the inevitable use of a sparse array aperture, the resulting beamformed image quality can be maintained by designing a custom convolutional encoder-decoder neural network to infer the radio frequency (RF) data of the nullified channels. This deep learning framework was trained with in vivo human carotid data (5-MHz plane wave imaging, 128 channels, 31 steering angles over a 30° span, and 62 799 frames in total). After training, the network was tested on an in vitro point target scenario that was dissimilar to the training data, in addition to in vivo carotid validation datasets. In the point target phantom image beamformed from inferred channel data, spatial aliasing artifacts attributed to array pitch doubling were found to be reduced by up to 10 dB. For carotid imaging, our proposed approach yielded a lumen-to-tissue contrast that was on average within 3 dB compared to the full-aperture image, whereas without channel data inferencing, the carotid lumen was obscured. When implemented on an RTX-2080 GPU, the inference time to apply the trained network was 4 ms, which favors real-time imaging. Overall, our technique shows that with the help of deep learning, channel data transfer rates can be effectively halved with limited impact on the resulting image quality.

On the Investigation of Autocorrelation-Based Vector Doppler Method With Plane Wave Imaging

Although color flow imaging is one of the representative applications of the Doppler method, it can estimate only the velocity component in the direction of ultrasonic propagation, that is, the axial velocity component. The vector Doppler method with high-frame-rate plane wave imaging overcomes such a limitation by estimating the blood flow velocity vectors using the axial velocities obtained by emitting plane waves in multiple directions. The autocorrelation technique can be used for the estimation of the axial velocity using the phase shift of an ultrasonic echo signal between two transmit-receive events. The technique also requires the frequency of the received echo signal. Although the center frequency of the emitted ultrasonic signal is commonly used in the estimation of axial velocities, the center frequency should be estimated from the received signals. In this study, a method for the estimation of the center frequency designed particularly for the high-frame-rate plane wave imaging was developed. The proposed method estimates the wavenumbers of the received signal in lateral and vertical directions to estimate the wavenumber in the axial direction, from which the center frequency was estimated. The beam steering angle was also estimated from the wavenumbers in the two directions. The effect of the proposed method was validated in simulations. The absolute bias error (ABE) and root-mean squared error in estimated velocity vectors obtained by plane wave imaging with three beam steering angles (-15°, 0°, and 15°) were reduced from 9.27% and 14.80% to 1.15% and 8.75%, respectively, by the proposed method. The applicability of the proposed method to in vivo measurements was also demonstrated using the in vivo recordings of human common carotid arteries. Physiologically consistent blood flow velocity distributions were obtained with respect to three subjects using the proposed method.

Forward-viewing estimation of 3D blood flow velocity fields by intravascular ultrasound: Influence of the catheter on velocity estimation in stenoses

Coronary artery disease is the most common type of cardiovascular disease, affecting > 18 million adults, and is responsible for > 365 k deaths per year in the U.S. alone. Wall shear stress (WSS) is an emerging indicator of likelihood of plaque rupture in coronary artery disease, however, non-invasive estimation of 3-D blood flow velocity and WSS is challenging due to the requirement for high spatial resolution at deep penetration depths in the presence of significant cardiac motion. Thus we propose minimally-invasive imaging with a catheter-based, 3-D intravascular forward-viewing ultrasound (FV US) transducer and present experiments to quantify the effect of the catheter on flow disturbance in stenotic vessel phantoms with realistic velocities and luminal diameters for both peripheral (6.33 mm) and coronary (4.74 mm) arteries. An external linear array ultrasound transducer was used to quantify 2-D velocity fields in vessel phantoms under various conditions of catheter geometry, luminal diameter, and position of the catheter relative to the stenosis at a frame rate of 5000 frames per second via a particle imaging velocimetry (PIV) approach. While a solid catheter introduced an underestimation of velocity measurement by > 20% relative to the case without a catheter, the hollow catheter introduced < 10% velocity overestimation, indicating that a hollow catheter design allowing internal blood flow reduces hemodynamic disturbance. In addition, for both peripheral and coronary arteries, the hollow catheter introduced < 3% deviation in flow velocity at the minimum luminal area compared to the control case. Finally, an initial comparison was made between velocity measurements acquired using a low frequency, catheter-based, 3-D intravascular FV US transducer and external linear array measurements, with relative error < 12% throughout the region of interest for a flow rate of 150 mL/min. While further system development is required, results suggest intravascular ultrasound characterization of blood flow velocity fields in stenotic vessels could be feasible with appropriate catheter design.

On the Depth-Dependent Accuracy of Plane-Wave-Based Vector Velocity Measurements With Linear Arrays

High-frame-rate vector Doppler methods are used to measure blood velocities over large 2-D regions, but their accuracy is often estimated over a short range of depths. This article thoroughly examines the dependence of velocity measurement accuracy on the target position. Simulations were carried out on flat and parabolic flow profiles, for different Doppler angles, and considering a 2-D vector flow imaging (2-D VFI) method based on plane wave transmission and speckle tracking. The results were also compared with those obtained by the reference spectral Doppler (SD) method. Although, as expected, the bias and standard deviation generally tend to worsen at increasing depths, the measurements also show the following. First, the errors are much lower for the flat profile (from ≈ -4 ± 3% at 20 mm to ≈ -17 ± 4% at 100 mm) than for the parabolic profile (from ≈ -4 ± 3% to ≈ -38 ±%). Second, only part of the relative estimation error is related to the inherent low resolution of the 2-D VFI method. For example, even for SD, the error bias increases (on average) from -0.7% (20 mm) to -17% (60 mm) up to -26% (100 mm). Third, conversely, the beam divergence associated with the linear array acoustic lens was found to have a great impact on the velocity measurements. By simply removing such lens, the average bias for 2-D VFI at 60 and 100 mm dropped down to -9.4% and -19.4%, respectively. In conclusion, the results indicate that the transmission beam broadening on the elevation plane, which is not limited by reception dynamic focusing, is the main cause of velocity underestimation in the presence of high spatial gradients.

Pulse Wave Imaging Coupled With Vector Flow Mapping: A Phantom, Simulation, and In Vivo Study

Pulse wave imaging (PWI) is an ultrasound imaging modality that estimates the wall stiffness of an imaged arterial segment by tracking the pulse wave propagation. The aim of the present study is to integrate PWI with vector flow imaging, enabling simultaneous and co-localized mapping of vessel wall mechanical properties and 2-D flow patterns. Two vector flow imaging techniques were implemented using the PWI acquisition sequence: 1) multiangle vector Doppler and 2) a cross-correlation-based vector flow imaging (CC VFI) method. The two vector flow imaging techniques were evaluated in vitro using a vessel phantom with an embedded plaque, along with spatially registered fluid structure interaction (FSI) simulations with the same geometry and inlet flow as the phantom setup. The flow magnitude and vector direction obtained through simulations and phantom experiments were compared in a prestenotic and stenotic segment of the phantom and at five different time frames. In most comparisons, CC VFI provided significantly lower bias or precision than the vector Doppler method ( ) indicating better performance. In addition, the proposed technique was applied to the carotid arteries of nonatherosclerotic subjects of different ages to investigate the relationship between PWI-derived compliance of the arterial wall and flow velocity in vivo. Spearman's rank-order test revealed positive correlation between compliance and peak flow velocity magnitude ( rs = 0.90 and ), while significantly lower compliance ( ) and lower peak flow velocity magnitude ( ) were determined in older (54-73 y.o.) compared with young (24-32 y.o.) subjects. Finally, initial feasibility was shown in an atherosclerotic common carotid artery in vivo. The proposed imaging modality successfully provided information on blood flow patterns and arterial wall stiffness and is expected to provide additional insight in studying carotid artery biomechanics, as well as aid in carotid artery disease diagnosis and monitoring.

In vitro performance of echoPIV for assessment of laminar flow profiles in a carotid artery stent

Purpose: Detailed blood flow studies may contribute to improvements in carotid artery stenting. High-frame-rate contrast-enhanced ultrasound followed by particle image velocimetry (PIV), also called echoPIV, is a technique to study blood flow patterns in detail. The performance of echoPIV in presence of a stent has not yet been studied extensively. We compared the performance of echoPIV in stented and nonstented regions in an in vitro flow setup.

Approach: A carotid artery stent was deployed in a vessel-mimicking phantom. High-frame-rate contrast-enhanced ultrasound images were acquired with various settings. Signal intensities of the contrast agent, velocity values, and flow profiles were calculated.

Results: The results showed decreased signal intensities and correlation coefficients inside the stent, however, PIV analysis in the stent still resulted in plausible flow vectors.

Conclusions: Velocity values and laminar flow profiles can be measured in vitro in stented arteries using echoPIV.

Two-dimensional iterative projection method for subsample speckle tracking of ultrasound images

Speckle tracking provides robust motion estimation necessary to create accurate post-processed images. These methods are known to be less accurate in the lateral dimension compared with the axial dimension due to the limitations on the lateral resolution of ultrasound scanning. This paper proposes a two-dimensional iterative projection (TDIP) algorithm using the Riesz transform to generate the analytic signals. The TDIP is an improvement to an already accurate speckle tracking algorithm called the phase coupled (PC) method. The PC method projects the intersection of gradients on the correlation map to the zero phase contour to estimate displacement. The TDIP method performs iterative projections and uses the aggregate of these projected locations to estimate the motion, in addition to rejecting inaccurate projections by checking them against the aggregate projection location. The TDIP additionally adopts the Riesz transform to generate two-dimensional analytic signals to improve lateral accuracy. The Riesz transform is a multidimensional extension of the Hilbert transform into the nD Euclidean space and therefore can be used to include data in both axial and lateral dimensions as opposed to the commonly used Hilbert transform which is one dimensional. The accuracy of the TDIP is quantitatively proven on simulated datasets from the Field II simulation program and on experimental data from two flow phantoms. At all cases, the TDIP is more accurate than the PC algorithm at two-dimensional displacement estimation. Graphical Abstract The lateral estimates from the Phase Coupled algorithm. This method uses the Hilbert transform for the analytic signal. There is large estimated motion within the flow blockage bounded by the red, fin shape in the center of the flow channel. The flow channel itself is also bounded by dashed, red lines. Graphical Abstract The lateral estimates from the TDIP method. This method is not tracking motion within the blockage in the center of the flow channel. The channel and the blockage are both bounded by dashed, red lines.

Estimation of High Velocities in Synthetic Aperture Imaging: I: Theory

The paper describes a new pulse sequence design and estimation approach, which can increase the maximum detectable velocity in synthetic aperture (SA) velocity imaging. In SA N spherical or plane waves are emitted, and the sequence is repeated continuously. The N emissions are combined to form a High Resolution Image (HRI). Correlation of HRIs is employed to estimate velocity, and the combination of N emissions lowers the effective pulse repetition frequency by N. Inter-leaving emission sequences can increase the effective pulse repetition frequency to the actual pulse repetition frequency, thereby increasing the maximum detectable velocity by a factor of N. This makes it possible to use longer sequences with better focusing properties. It can also increase the possible interrogation depth for vessels with large velocities. A new cross-correlation vector flow estimator is also presented, which can further increase the maximum detectable velocity by a factor of three. It is based on Transverse Oscillation (TO), a pre-processing stage, and cross-correlation of signals beamformed orthogonal to the ultrasound propagation direction. The estimator is self-calibrating without estimating the lateral TO wavelength. This paper develops the theory behind the two methods. The performance is demonstrated in the accompanying paper for convex and phased array probes connected to the SARUS scanner for parabolic flow for both conventional and SA imaging.

Vector Flow Imaging Compared with Digital Subtraction Angiography for Stenosis Assessment in the Superficial Femoral Artery - A Study of Vector Concentration, Velocity Ratio and Stenosis Degree Percentage

Purpose

Stenosis of the superficial femoral artery (SFA) induces complex blood flow with increased velocities. Disease assessment is performed with Doppler ultrasound and digital subtraction angiography (DSA), but Doppler ultrasound is limited by angle dependency and DSA by ionizing radiation. An alternative is the vector flow imaging method based on transverse oscillation (TO), an angle-independent vector velocity technique using ultrasound. In this study, flow complexity and velocity measured with TO were compared with DSA for the assessment of stenosis in the SFA.

Materials and Methods

The vector concentration, a measure of flow complexity, and the velocity ratio obtained from the stenosis and a disease-free adjacent vessel segment, were estimated with TO in 11 patients with a total of 16 stenoses of the SFA. TO data were compared with the corresponding stenosis degree percentage obtained with DSA.

Results

The correlation between the vector concentration and DSA was very strong (R=0.93; p<0.001; 95% confidence interval (CI): 0.81-0.98), while only moderate for velocity ratio and DSA (R=0.50; p<0.07; 95% CI: 0.00-0.80). The correlation coefficients that were found were significantly different (p<0.005) without overlapping CI.

Conclusion

The study indicated that flow changes in the SFA induced by stenosis can be quantified with TO, and that stenosis grading may be improved by estimation of flow complexity instead of velocity ratio. TO is a potential diagnostic tool for the assessment of atherosclerosis and peripheral arterial disease.

Fast Flow-Line-Based Analysis of Ultrasound Spectral and Vector Velocity Estimators

A new technique, termed FLUST (FlowLine Ultrasound Simulation Tool), is proposed as a computationally cheap alternative to simulations based on randomly positioned scatterers for the simulation of stationary blood velocity fields. In FLUST, the flow field is represented as a collection of flow lines. Point spread functions are first calculated at regularly spaced positions along the flow lines before realizations of single scatterers traversing the flow lines are generated using temporal interpolation. Several flow-line realizations are then generated by convolution with temporal noise filters, and finally, flow-field realizations are obtained by the summation of the individual flow-line realizations. Flow-field realizations produced by FLUST are shown to correspond well with conventional Field II simulations both quantitatively and qualitatively. The added value of FLUST is demonstrated by using the proposed simulation technique to obtain multiple realizations of realistic 3-D flow fields at a significantly reduced computational cost. This information is utilized for a performance assessment of different spectral and vector velocity estimators for carotid and coronary imaging applications. The computational load of FLUST does not increase substantially with the number of realizations or simulated frames, and for the examples shown, it is the fastest alternative when the total number of simulated frames exceeds 48. In the examples, the standard deviation and bias of the velocity estimators are calculated using 100 FLUST realizations, in which case the proposed method is two orders of magnitude faster than simulations based on random scatterer positions.

Accuracy and Precision of a Plane Wave Vector Flow Imaging Method in the Healthy Carotid Artery

The objective of the study described here was to investigate the accuracy and precision of a plane wave 2-D vector flow imaging (VFI) method in laminar and complex blood flow conditions in the healthy carotid artery. The approach was to study (i) the accuracy for complex flow by comparing the velocity field from a computational fluid dynamics (CFD) simulation to VFI estimates obtained from the scan of an anthropomorphic flow phantom and from an in vivo scan; (ii) the accuracy for laminar unidirectional flow in vivo by comparing peak systolic velocities from VFI with magnetic resonance angiography (MRA); (iii) the precision of VFI estimation in vivo at several evaluation points in the vessels. The carotid artery at the bifurcation was scanned using both fast plane wave ultrasound and MRA in 10 healthy volunteers. The MRA geometry acquired from one of the volunteers was used to fabricate an anthropomorphic flow phantom, which was also scanned using the fast plane wave sequence. The same geometry was used in a CFD simulation to calculate the velocity field. Results indicated that similar flow patterns and vortices were estimated with CFD and VFI in the phantom for the carotid bifurcation. The root-mean-square difference between CFD and VFI was within 0.12 m/s for velocity estimates in the common carotid artery and the internal branch. The root-mean-square difference was 0.17 m/s in the external branch. For the 10 volunteers, the mean difference between VFI and MRA was -0.17 m/s for peak systolic velocities of laminar flow in vivo. The precision in vivo was calculated as the mean standard deviation (SD) of estimates aligned to the heart cycle and was highest in the center of the common carotid artery (SD = 3.6% for velocity magnitudes and 4.5° for angles) and lowest in the external branch and for vortices (SD = 10.2% for velocity magnitudes and 39° for angles). The results indicate that plane wave VFI measures flow precisely and that estimates are in good agreement with a CFD simulation and MRA.

Real-Time Blood Velocity Vector Measurement Over a 2-D Region

Quantitative blood velocity measurements, as currently implemented in commercial ultrasound scanners, are based on pulsed-wave (PW) spectral Doppler and are limited to detect the axial component of the velocity in a single sample volume. On the other hand, vector Doppler methods produce angle-independent estimates by, e.g., combining the frequency shifts measured from different directions. Moreover, thanks to the transmission of plane waves, the investigation of a 2-D region is possible with high temporal resolution, but, unfortunately, the clinical use of these methods is hampered by the massive calculation power required for their real-time execution. In this paper, we present a novel approach based on the transmission of plane waves and the simultaneous reception of echoes from 16 distinct subapertures of a linear array probe, which produces eight lines distributed over a 2-D region. The method was implemented on the ULAO-OP 256 research scanner and tested both in phantom and in vivo. A continuous real-time refresh rate of 36 Hz was achieved in duplex combination with a standard B-mode at pulse repetition frequency of 8 kHz. Accuracies of -11% on velocity and of 2°on angle measurements have been obtained in phantom experiments. Accompanying movies show how the method improves the quantitative measurements of blood velocities and details the flow configurations in the carotid artery of a volunteer.

A Vector Flow Imaging Method for Portable Ultrasound Using Synthetic Aperture Sequential Beamforming

This paper presents a vector flow imaging method for the integration of quantitative blood flow imaging in portable ultrasound systems. The method combines directional transverse oscillation (TO) and synthetic aperture sequential beamforming to yield continuous velocity estimation in the whole imaging region. Six focused emissions are used to create a high-resolution image (HRI), and a dual-stage beamforming approach is used to lower the data throughput between the probe and the processing unit. The transmit/receive focal points are laterally separated to obtain a TO in the HRI that allows for the velocity estimation along the lateral and axial directions using a phase-shift estimator. The performance of the method was investigated with constant flow measurements in a flow rig system using the SARUS scanner and a 4.1-MHz linear array. A sequence was designed with interleaved B-mode and flow emissions to obtain continuous data acquisition. A parametric study was carried out to evaluate the effect of critical parameters. The vessel was placed at depths from 20 to 40 mm, with beam-to-flow angles of 65°, 75°, and 90°. For the lateral velocities at 20 mm, a bias between -5% and -6.2% was obtained, and the standard deviation (SD) was between 6% and 9.6%. The axial bias was lower than 1% with an SD around 2%. The mean estimated angles were 66.70° ± 2.86°, 72.65° ± 2.48°, and 89.13° ± 0.79° for the three cases. A proof-of-concept demonstration of the real-time processing and wireless transmission was tested in a commercial tablet obtaining a frame rate of 27 frames/s and a data rate of 14 MB/s. An in vivo measurement of a common carotid artery of a healthy volunteer was finally performed to show the potential of the method in a realistic setting. The relative SD averaged over a cardiac cycle was 4.33%.

Common Carotid Artery Flow Measured by 3-D Ultrasonic Vector Flow Imaging and Validated with Magnetic Resonance Imaging

Ultrasound (US) examination of the common carotid artery was compared with a through-plane magnetic resonance imaging (MRI) sequence to validate a recently proposed technique for 3-D US vector flow imaging. Data from the first volunteer examined were used as the training set, before volume flow and peak velocities were calculated for the remaining eight volunteers. Peak systolic velocities (PSVs) and volume flow obtained with 3-D US were, on average, 34% higher and 24% lower than those obtained with MRI, respectively. A high correlation was observed for PSV (r = 0.79), whereas a lower correlation was observed for volume flow (r = 0.43). The overall standard deviations were ±5.7% and ±5.7% for volume flow and PSV with 3-D US, compared with ±2.7% and ±3.2% for MRI. Finally, the data were re-processed with a change in the parameter settings for the echo-canceling filter to investigate its influence on overall performance. PSV was less affected by the re-processing, whereas the difference in volume flow between 3-D vector flow imaging and MRI was reduced to -9%, and with an improved overall standard deviation of ±4.7%. The results illustrate the feasibility of using 3-D US for precise and angle-independent volume flow and PSV estimation in vivo.

Architecture of an Ultrasound System for Continuous Real-Time High Frame Rate Imaging

High frame rate (HFR) imaging methods based on the transmission of defocused or plane waves rather than focused beams are increasingly popular. However, the production of HFR images poses severe requirements both in the transmission and the reception sections of ultrasound scanners. In particular, major technical difficulties arise if the images must be continuously produced in real-time, i.e., without any acquisition interruption nor loss of data. This paper presents the implementation of the real-time HFR-compounded imaging application in the ULA-OP 256 research platform. The beamformer sustains an average output sample rate of 470 MSPS. This allows continuously producing coherently compounded images, each of 64 lines by 1280 depths (here corresponding to 15.7 mm width and 45 mm depth, respectively), at frame rates up to 5.3 kHz. Imaging tests addressed to evaluate the achievable speed and quality performance were conducted on phantom. Results obtained by real-time compounding frames obtained with different numbers of steering angles between +7.5° and -7.5° are presented.

Directional Transverse Oscillation Vector Flow Estimation

A method for estimating vector velocities using transverse oscillation (TO) combined with directional beamforming is presented. In directional TO (DTO), a normal focused field is emitted and the received signals are beamformed in the lateral direction transverse to the ultrasound beam to increase the amount of data for vector velocity estimation. The approach is self-calibrating as the lateral oscillation period is estimated from the directional signal through a Fourier transform to yield quantitative velocity results over a large range of depths. The approach was extensively simulated using Field IIpro and implemented on the experimental Synthetic Aperture Real-time Ultrasound System (SARUS) scanner in connection with a BK Medical 8820e convex array transducer. Velocity estimates for DTO are found for beam-to-flow angles of 60°, 75°, and 90°, and vessel depths from 24 to 156 mm. Using 16 emissions, the standard deviation (SD) for angle estimation at depths ranging from 24 to 104 mm is between 6.01° and 0.93° with a mean SD of 2.8°. The mean relative SD for the lateral velocity component is 9.2% and the mean relative bias -3.4% or four times lower than for traditional TO. The approach also works for deeper lying vessels with a slight increase in SD to 15.7%, but a maintained bias of -3.5% from 126 to 156 mm. Data for a pulsating flow have also been acquired for 15 cardiac cycles using a CompuFlow 1000 pump. The relative SD was here 7.4% for a femoral artery waveform.

Fast Plane Wave 2-D Vector Flow Imaging Using Transverse Oscillation and Directional Beamforming

Several techniques can estimate the 2-D velocity vector in ultrasound. Directional beamforming (DB) estimates blood flow velocities with a higher precision and accuracy than transverse oscillation (TO), but at the cost of a high beamforming load when estimating the flow angle. In this paper, it is proposed to use TO to estimate an initial flow angle, which is then refined in a DB step. Velocity magnitude is estimated along the flow direction using cross correlation. It is shown that the suggested TO-DB method can improve the performance of velocity estimates compared with TO, and with a beamforming load, which is 4.6 times larger than for TO and seven times smaller than for conventional DB. Steered plane wave transmissions are employed for high frame rate imaging, and parabolic flow with a peak velocity of 0.5 m/s is simulated in straight vessels at beam-to-flow angles from 45° to 90°. The TO-DB method estimates the angle with a bias and standard deviation (SD) less than 2°, and the SD of the velocity magnitude is less than 2%. When using only TO, the SD of the angle ranges from 2° to 17° and for the velocity magnitude up to 7%. Bias of the velocity magnitude is within 2% for TO and slightly larger but within 4% for TO-DB. The same trends are observed in measurements although with a slightly larger bias. Simulations of realistic flow in a carotid bifurcation model provide visualization of complex flow, and the spread of velocity magnitude estimates is 7.1 cm/s for TO-DB, while it is 11.8 cm/s using only TO. However, velocities for TO-DB are underestimated at peak systole as indicated by a regression value of 0.97 for TO and 0.85 for TO-DB. An in vivo scanning of the carotid bifurcation is used for vector velocity estimations using TO and TO-DB. The SD of the velocity profile over a cardiac cycle is 4.2% for TO and 3.2% for TO-DB.

Vector velocity estimation of blood flow - A new application in medical ultrasound

Vector flow techniques in the field of ultrasound encompass different pulse emission and estimation strategies. Numerous techniques have been introduced over the years, and recently commercial implementations usable in the clinic have been made. A number of clinical papers using different vector velocity approaches have been published. This review will give an overview of the most significant in vivo results achieved with ultrasound vector flow techniques, and will outline some of the possible clinical applications for vector velocity estimation in the future.

Low-Cost 3-D Flow Estimation of Blood With Clutter

Volumetric flow rate estimation is an important ultrasound medical imaging modality that is used for diagnosing cardiovascular diseases. Flow rates are obtained by integrating velocity estimates over a cross-sectional plane. Speckle tracking is a promising approach that overcomes the angle dependency of traditional Doppler methods, but suffers from poor lateral resolution. Recent work improves lateral velocity estimation accuracy by reconstructing a synthetic lateral phase (SLP) signal. However, the estimation accuracy of such approaches is compromised by the presence of clutter. Eigen-based clutter filtering has been shown to be effective in removing the clutter signal; but it is computationally expensive, precluding its use at high volume rates. In this paper, we propose low-complexity schemes for both velocity estimation and clutter filtering. We use a two-tiered motion estimation scheme to combine the low complexity sum-of-absolute-difference and SLP methods to achieve subpixel lateral accuracy. We reduce the complexity of eigen-based clutter filtering by processing in subgroups and replacing singular value decomposition with less compute-intensive power iteration and subspace iteration methods. Finally, to improve flow rate estimation accuracy, we use kernel power weighting when integrating the velocity estimates. We evaluate our method for fast- and slow-moving clutter for beam-to-flow angles of 90° and 60° using Field II simulations, demonstrating high estimation accuracy across scenarios. For instance, for a beam-to-flow angle of 90° and fast-moving clutter, our estimation method provides a bias of -8.8% and standard deviation of 3.1% relative to the actual flow rate.

Ultrasonic 3-D Vector Flow Method for Quantitative In Vivo Peak Velocity and Flow Rate Estimation

Current clinical ultrasound (US) systems are limited to show blood flow movement in either 1-D or 2-D. In this paper, a method for estimating 3-D vector velocities in a plane using the transverse oscillation method, a 32×32 element matrix array, and the experimental US scanner SARUS is presented. The aim of this paper is to estimate precise flow rates and peak velocities derived from 3-D vector flow estimates. The emission sequence provides 3-D vector flow estimates at up to 1.145 frames/s in a plane, and was used to estimate 3-D vector flow in a cross-sectional image plane. The method is validated in two phantom studies, where flow rates are measured in a flow-rig, providing a constant parabolic flow, and in a straight-vessel phantom ( ∅=8 mm) connected to a flow pump capable of generating time varying waveforms. Flow rates are estimated to be 82.1 ± 2.8 L/min in the flow-rig compared with the expected 79.8 L/min, and to 2.68 ± 0.04 mL/stroke in the pulsating environment compared with the expected 2.57 ± 0.08 mL/stroke. Flow rates estimated in the common carotid artery of a healthy volunteer are compared with magnetic resonance imaging (MRI) measured flow rates using a 1-D through-plane velocity sequence. Mean flow rates were 333 ± 31 mL/min for the presented method and 346 ± 2 mL/min for the MRI measurements.

Ultrasound imaging velocimetry with interleaved images for improved pulsatile arterial flow measurements: a new correction method, experimental and in vivo validation

Blood velocity measurements are important in physiological science and clinical diagnosis. Doppler ultrasound is the most commonly used method but can only measure one velocity component. Ultrasound imaging velocimetry (UIV) is a promising technique capable of measuring two velocity components; however, there is a limit on the maximum velocity that can be measured with conventional hardware which results from the way images are acquired by sweeping the ultrasound beam across the field of view. Interleaved UIV is an extension of UIV in which two image frames are acquired concurrently, allowing the effective interframe separation time to be reduced and therefore increasing the maximum velocity that can be measured. The sweeping of the ultrasound beam across the image results in a systematic error which must be corrected: in this work, we derived and implemented a new velocity correction method which accounts for acceleration of the scatterers. We then, for the first time, assessed the performance of interleaved UIV for measuring pulsatile arterial velocities by measuring flows in phantoms and in vivo and comparing the results with spectral Doppler ultrasound and transit-time flow probe data. The velocity and flow rate in the phantom agreed within 5-10% of peak velocity, and 2-9% of peak flow, respectively, and in vivo the velocity difference was 9% of peak velocity. The maximum velocity measured was 1.8 m s^-1, the highest velocity reported with UIV. This will allow flows in diseased arteries to be investigated and so has the potential to increase diagnostic accuracy and enable new vascular research.

A Sparse Reconstruction Framework for Fourier-Based Plane-Wave Imaging

Ultrafast imaging based on plane-wave (PW) insonification is an active area of research due to its capability of reaching high frame rates. Among PW imaging methods, Fourier-based approaches have demonstrated to be competitive compared with traditional delay and sum methods. Motivated by the success of compressed sensing techniques in other Fourier imaging modalities, like magnetic resonance imaging, we propose a new sparse regularization framework to reconstruct highquality ultrasound (US) images. The framework takes advantage of both the ability to formulate the imaging inverse problem in the Fourier domain and the sparsity of US images in a sparsifying domain. We show, by means of simulations, in vitro and in vivo data, that the proposed framework significantly reduces image artifacts, i.e., measurement noise and sidelobes, compared with classical methods, leading to an increase of the image quality.

Ultrasound Vector Flow Imaging-Part II: Parallel Systems

This paper gives a review of the current state-of-the-art in ultrasound parallel acquisition systems for flow imaging using spherical and plane waves emissions. The imaging methods are explained along with the advantages of using these very fast and sensitive velocity estimators. These experimental systems are capable of acquiring thousands of images per second for fast moving flow as well as yielding the estimates of low velocity flow. These emerging techniques allow the vector flow systems to assess highly complex flow with transitory vortices and moving tissue, and they can also be used in functional ultrasound imaging for studying brain function in animals. This paper explains the underlying acquisition and estimation methods for fast 2-D and 3-D velocity imaging and gives a number of examples. Future challenges and the potentials of parallel acquisition systems for flow imaging are also discussed.

Investigation of Crossbeam Multi-receiver Configurations for Accurate 3-D Vector Doppler Velocity Estimation

An accurate estimation of low blood velocities whose Doppler shifts span the wall filter cutoff, such as near the wall in recirculation or disturbed flow regions, is important for accurate mapping of velocities to achieve improved estimations of wall shear stress and turbulence, which are known risk factors for atherosclerosis and stroke. This paper presents the comparative benefit of increasing the number of receiver beams above three for an improved estimation of low 3-D velocities. The 3-D crossbeam vector Doppler ultrasound configurations were studied in terms of the number of receiver beams, interbeam angle, and beam selection method (criterion for discriminating between tissue and blood Doppler signals) for a range of velocity orientations, which may prove useful in the design of a future 2-D array for vascular imaging. For maximum velocity resolution, a shallow gradient of low flow velocities up to 5 cm/s was generated across a large-diameter (2.46 cm) straight vessel. Data were acquired using a linear array rotated around the central transmit beam axis to generate three- to eight-receiver (3R-8R) configurations;the rotation of each configuration relative to the flow axis was used to mimic a broad range of velocity vector orientations. Accuracy and precision for ≥5 receivers were consistently better over all velocity orientations and for all selection methods. For a velocity magnitude of 2 cm/s, the best accuracy and precision in both magnitude and direction (~21% ± 13%, <1° ± 9°, respectively) were seen with a 5R configuration using a weighted least-squares selection method. Asymmetry in the 5R configuration led to an improved accuracy and precision compared with that in symmetrical 6R and 8R configurations. The results demonstrated relatively little to no benefit from more than five receiver beams.

3-D Vector Flow Estimation With Row-Column-Addressed Arrays

Simulation and experimental results from 3-D vector flow estimations for a 62 + 62 2-D row-column (RC) array with integrated apodization are presented. A method for implementing a 3-D transverse oscillation (TO) velocity estimator on a 3-MHz RC array is developed and validated. First, a parametric simulation study is conducted, where flow direction, ensemble length, number of pulse cycles, steering angles, transmit/receive apodization, and TO apodization profiles and spacing are varied, to find the optimal parameter configuration. The performance of the estimator is evaluated with respect to relative mean bias ~B and mean standard deviation ~σ . Second, the optimal parameter configuration is implemented on the prototype RC probe connected to the experimental ultrasound scanner SARUS. Results from measurements conducted in a flow-rig system containing a constant laminar flow and a straight-vessel phantom with a pulsating flow are presented. Both an M-mode and a steered transmit sequence are applied. The 3-D vector flow is estimated in the flow rig for four representative flow directions. In the setup with 90° beam-to-flow angle, the relative mean bias across the entire velocity profile is (-4.7, -0.9, 0.4)% with a relative standard deviation of (8.7, 5.1, 0.8)% for ( v_x, v_y, v_z ). The estimated peak velocity is 48.5 ± 3 cm/s giving a -3% bias. The out-of-plane velocity component perpendicular to the cross section is used to estimate volumetric flow rates in the flow rig at a 90° beam-to-flow angle. The estimated mean flow rate in this setup is 91.2 ± 3.1 L/h corresponding to a bias of -11.1%. In a pulsating flow setup, flow rate measured during five cycles is 2.3 ± 0.1 mL/stroke giving a negative 9.7% bias. It is concluded that accurate 3-D vector flow estimation can be obtained using a 2-D RC-addressed array.

Accurate Angle Estimator for High-Frame-Rate 2-D Vector Flow Imaging

This paper presents a novel approach for estimating 2-D flow angles using a high-frame-rate ultrasound method. The angle estimator features high accuracy and low standard deviation (SD) over the full 360° range. The method is validated on Field II simulations and phantom measurements using the experimental ultrasound scanner SARUS and a flow rig before being tested in vivo. An 8-MHz linear array transducer is used with defocused beam emissions. In the simulations of a spinning disk phantom, a 360° uniform behavior on the angle estimation is observed with a median angle bias of 1.01° and a median angle SD of 1.8°. Similar results are obtained on a straight vessel for both simulations and measurements, where the obtained angle biases are below 1.5° with SDs around 1°. Estimated velocity magnitudes are also kept under 10% bias and 5% relative SD in both simulations and measurements. An in vivo measurement is performed on a carotid bifurcation of a healthy individual. A 3-s acquisition during three heart cycles is captured. A consistent and repetitive vortex is observed in the carotid bulb during systoles.