Abstract:
A method of measuring blood flow including several steps. In an initial step a first ultrasound beam is oriented in a direction substantially perpendicular to the direction of the blood flow to be measured. Next, the Doppler spectrum obtained from the backscattered echoes of said first ultrasound beam is measured. Subsequently, the ultrasound beam is reoriented so that the Doppler spectrum of the backscattered echoes of the ultrasound beam is substantially symmetrical around the zero frequency. The Doppler frequency of the backscattered echoes of a second ultrasound beam oriented at a fixed angle to the first ultrasound beam is then measured. Finally, the rate of blood flow is calculated based on the angle between the ultrasound beams and the measured Doppler frequency of the backscattered echoes of the second ultrasound beam.

Description:
FIELD OF THE INVENTION 
     The present invention relates to the technical field of fluid flow rate measurement through the use of ultrasound, particularly in relation to blood flow. 
     DESCRIPTION OF RELATED ART 
     The use of ultrasound to measure blood flow is well known. According to the Doppler effect, a flow with velocity v impinged by a planar ultrasound (US) wave with centre frequency f 0 , generates echoes characterized by a frequency shift: 
                     f   1     =         2   ⁢     f   0       c     ⁢        v        ⁢   cos   ⁢           ⁢   θ             eqn   .           ⁢   1               
where c is the velocity of US and θ is the beam-to flow angle. By measuring the frequency f 1 , the axial component, |v|×cos θ, of the velocity magnitude, |v|, is estimated. However, as traditional Doppler methods only measure the axial component of the velocity vector, it is not possible to estimate the individual contribution of |v| or θ. The lack of information on the beam-to-flow angle creates an ambiguity which can lead to large errors in velocity magnitude estimates.
 
     Several methods have been proposed to obtain angle independent blood velocity estimates. The standard approach is based on the combination of Doppler measurements taken along multiple US beams intersecting in the region of interest. The basic idea consists in measuring the Doppler frequencies received from the same sample volume (SV) insonified by two (or more) transducers whose beam axes are oriented along directions describing a known angle δ. Through a trigonometric combination of the Doppler equations related to the frequencies obtained by the two transducers, both the velocity magnitude and the flow direction can be estimated. 
     SUMMARY OF THE INVENTION 
     The present invention proposes a new method for estimating the Doppler angle and the velocity magnitude, by using a configuration in which two ultrasound beams with known relative orientation are directed toward the same vessel. One of the beams is committed to perform a Doppler measurement, while a second (reference) beam has the specific task of detecting the beam-to-flow angle. A substantially perpendicular beam-to-flow angle can be obtained by reorienting the reference beam to obtain optimal spectral symmetry. Once the flow direction is known thanks to the reference beam, the velocity magnitude can be directly measured by the other ultrasound beam. 
     The two transducers of the invention perform completely different tasks: one transducer is used only to determine the flow direction, while the other has to perform a classic Doppler frequency measurement. This is possible by exploiting specific features of the Doppler spectrum, which are typical of the transverse beam-to-flow orientation. 
     One embodiment of the present invention is a system and method for measuring the rate of blood flow. In this embodiment a reference transducer is aligned to be substantially perpendicular to the blood flow to be measured. The symmetry of the Doppler spectra of the echoes backscattered to the reference transducer is measured and the transducer is reoriented so that the measured Doppler spectra is substantially symmetrical. A second ultrasonic transducer, oriented at a fixed angle to the reference transducer is then used to measure the Doppler frequency and the rate of blood flow is calculated based on these measurements and the known angle of the second transducer with respect to the direction of the blood flow. 
     The present invention can also be implemented using a linear array probe. In the linear array probe a first subaperture operates as the reference ultrasonic transducer and a second subaperture operates as the second ultrasonic transducer. 
     In at least one embodiment, the system further comprises an actuator for automatically reorienting the first ultrasonic transducer to an orientation substantially perpendicular to the rate of blood flow to be measured. 
     In an exemplary embodiment, the second subaperture is selectable from two or more subapertures. 
     A system for measuring the rate of blood flow according to an exemplary embodiment of the present invention comprises: a first ultrasonic transducer, a second ultrasonic transducer oriented at a fixed angle to the first ultrasonic transducer, a computer configured to determine when a Doppler frequency spectrum obtained from backscattered echoes of the first ultrasonic transducer is substantially symmetrical around a zero frequency, thereby indicating that a beam to flow angle of the first ultrasonic transducer is at approximately 90 degrees; a beam to flow angle of the second ultrasonic transducer based on the indicated beam to flow angle of the first ultrasonic transducer and the fixed angle; and means for calculating the rate of blood flow based upon the beam to flow angle of the second ultrasonic transducer and Doppler frequency of backscattered echoes of the second ultrasonic transducer. 
     In an exemplary embodiment, the computer generates a viewable graphical representation of the symmetry of the Doppler spectrum around the zero frequency. 
     In an exemplary embodiment, the computer generates a viewable numerical representation of the symmetry of the Doppler spectrum around the zero frequency. 
     In an exemplary embodiment, the first ultrasonic transducer comprises a first subaperture of a linear array probe, and the second ultrasonic transducer comprises a second subaperture of the linear array probe. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  illustrates the geometry of the dual-beam system. 
         FIG. 2  illustrates a spectrogram obtained from a transversely insonated carotid artery. 
         FIG. 3  illustrates a linear array probe operating over a blood vessel. 
         FIG. 4  illustrates ensemble averaged Doppler spectra obtained at a beam-vessel angle of 90°. 
         FIG. 5  illustrates ensemble averaged Doppler spectra obtained at a beam-vessel angle of 88°. 
         FIG. 6  illustrates velocity magnitudes recorded with a dual-beam system by employing 3 different interbeam angles. 
     
    
    
     DETAILED DESCRIPTION 
     The present invention is a novel dual beam technique and system for performing that technique, which utilizes the specific features of Doppler spectra obtained at transverse beam-to-flow orientations. Unlike other approaches inspired by Newhouse&#39;s transverse Doppler theory, Doppler bandwidth does not have to be measured. By taking only the spectral symmetry into consideration for Doppler angle estimation, such angle could be estimated with errors lower than 1° through either subjective (operator dependent) and objective (SI-based) methods. 
     Classic cross-beam methods assume that the Doppler frequencies obtained from the two beams are due to the same velocity distribution, which is true only if the two transducers interrogate exactly the same SV. This goal, in general, is difficult to achieve, especially for non-spherical SVs and large interbeam angles. On the other hand, the performance is known to deteriorate as the angle between the beams is reduced. 
     The new method can be applied in any Doppler measurement in which a transverse insonification is compatible with the depth and the orientation of the vessel. The common carotid artery, being almost parallel to the skin, represents an ideal field of application for this technique. Both the reference beam and the measurement beam can be easily set along suitable directions through standard (steerable) linear array probes. The descending aorta, being almost parallel and quite close to the esophagus, is also suitable for application of the method when trans-esophageal probes are used. 
     As shown in  FIG. 1 , the system of the present invention has two ultrasonic transducers, a measuring transducer  1  and reference transducer  2 , respectively, interrogating the same region of blood vessel  3  with beam-to-flow angles θ 1  and θ 2 , respectively. The interbeam angle, δ, is fixed at a predetermined angle. 
     The task of estimating the Doppler angle is performed through the reference transducer  2 . The task of estimating the velocity magnitude is performed through the measuring transducer  1 . 
     The reference beam-to-flow direction is uniquely determined by the characteristics of the Doppler spectrum obtained from the backscattered echoes of reference transducer  2 . It is possible to evaluate such angle by analyzing how the Doppler spectral components are actually distributed. 
     The reference direction can be chosen substantially at 90° with respect to the flow being the Doppler spectrum of the backscattered echo in that direction substantially symmetrical around the zero frequency.  FIG. 2  shows an example of such a substantially symmetrical Doppler spectrum. This property of the Doppler spectrum, is derived from the transducer focusing features, which involve a set of effective beam-to flow angles equally distributed around a nominal 90° angle. 
     Since the mean Doppler frequency of the received signal is related to the cosine of the nominal Doppler angle, a small deviation from the desired transverse orientation causes a visible loss of symmetry. 
     The extent at which the spectrum is actually symmetrical can be evaluated in different ways. For example, it can be based on the direct observation of the real time spectrogram. 
     To avoid any operator-dependence, the actual distribution of Doppler power between positive and negative sub-bands can be taken into consideration through the evaluation of a Symmetry index (SI) defined, e.g., as: 
             SI   =         Doppler   ⁢             ⁢             ⁢   power   ⁢           ⁢   distributed   ⁢           ⁢   over   ⁢             ⁢             ⁢   positive   ⁢           ⁢   frequencies       Doppler   ⁢           ⁢   power   ⁢             ⁢             ⁢   distributed   ⁢           ⁢   over   ⁢           ⁢   negative   ⁢           ⁢   frequencies       ⨯   100           
in which the numerator and denominator are automatically exchanged when the ratio is &gt;1. When θ 2 =90°, the SI should be ideally equal to 100%. However, since even a small deviation from 90° causes an appreciable loss of symmetry, a range of values lower than 100% can be considered acceptable. Preferably, θ 2  should deviate from 90° by less than 2°. More preferably, θ 2  should deviate from 90° by less than 1°.
 
     In a preferred embodiment, reference transducer  1  may be automatically reoriented by an actuator to achieve a reference direction of substantially 90°. By monitoring the changes to the SI value for reference transducer  1 , a computer system can send the appropriate signals to the actuator to adjust the orientation of reference transducer  1 . 
     Finally, once the flow direction has been accurately determined, the beam-to-flow angle θ 1  can be automatically determined by subtracting the known interbeam angle, δ, from 90°. 
     Once the angle of insonation for the measurement beam, θ 1 , has been estimated, the mean velocity within the investigated SV can be directly evaluated through eqn. 1, in which f 1  represents the mean frequency of the selected Doppler signal. As a possible alternative, since the full Doppler spectrum is available, the local peak velocity can be estimated from: 
                     V   max     =       f   max           2   ⁢     f   0       c     ⁢     (       cos   ⁢           ⁢     θ   1       +       k   ⨯   sin     ⁢           ⁢     θ   1         )                 eqn   .           ⁢   2               
in which f max  is the spectrum peak frequency and k is a factor of proportionality depending on the transducer geometry. The second term in the denominator allows correcting for intrinsic spectral broadening effects.
 
     The method of the present invention also provides advantages when used in conjunction with linear array probes. The optimal reference beam direction can be automatically set by tracking the steering angle which maximizes the spectral symmetry. This could be achieved by monitoring a symmetry index. Once the reference beam direction and the related SV depth have been fixed, the system can easily calculate the best options (in terms of position and steering angle) for the measuring beam, and automatically select the subaperture more suitable to generate such beam. These automatic procedures can be adapted to existing ultrasonic machines in order to obtain the benefits of the invention. 
       FIG. 3  shows a preferred embodiment of the invention in a system having a linear array probe  4 . In this system, subaperture  5  is used to generate the reference beam and subaperture  6  is used to generate the measuring beam. 
     The teaching of the present invention is suitable for application in all systems employing spectral analysis for Doppler velocity measurement, including, in particular, multigate spectral Doppler systems. Although the invention has been described with reference to particular embodiments, there is no intention to restrict the scope of the invention, and indeed many other modifications and variations will be ascertainable to those of skill in the art. 
     EXAMPLE 
     The software of a commercial ultrasound machine (Megas by Esaote SpA, Florence, Italy) was customized to make possible the simultaneous selection of two independent M-lines in a standard B-mode display of the ROI as shown in  FIG. 3 . 
     The TX-RX process involves two independent subapertures of the linear array transducer. When switched to “Dual” PW-mode, the system fires the elements of the linear array probe in such a way that US bursts are alternatively transmitted from each sub-aperture. Echo signals backscattered from the SV intercepted by both such lines are processed so that the corresponding spectrograms are calculated and displayed on a PC screen in real-time. 
     The method of the present invention was tested in vitro by using a phantom in which it was possible to control the velocity for both steady and pulsatile flow conditions. Distilled water was forced to flow in a 10 mm internal diameter Rilsan tube. Orgasol particles were used for scattering purposes. 
       FIGS. 4 and 5  shows a comparison of typical ensemble (N=100) averaged Doppler spectra obtained from the reference beam at angles of approximately 90° and 88°, respectively. As shown, even a small deviation from 90° makes the Doppler spectrum strongly asymmetrical. 
     In the experiment of this example, the beam-to-flow angle was manually changed in steps of 1° around 90°. For each angle, the Symmetry index was estimated for: a) steady flow (volume flow: Q=250 ml/min); b) steady flow (Q=450 ml/min); c) pulsatile flow (Q=300 ml/min). During each acquisition, typically 2 seconds long, one SI was estimated every 20 ms. Table A reports the average SI measured for each angle in the range 85°-95°. This table clearly shows that the SI dramatically falls down for deviations of a few degrees from the transverse orientation. 
     
       
         
               
               
               
               
               
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
               
               
               
               
               
               
             
           
               
                 TABLE A 
               
               
                   
               
               
                 α [°] 
                 85 
                 86 
                 87 
                 88 
                 89 
                 90 
                 91 
                 92 
                 93 
                 94 
                 95 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                 SI [%] 
                 a) 
                 26 
                 38 
                 52 
                 67 
                 85 
                 90 
                 61 
                 43 
                 26 
                 16 
                 13 
               
               
                   
                 b) 
                 22 
                 35 
                 48 
                 53 
                 76 
                 87 
                 62 
                 39 
                 15 
                 10 
                 7 
               
               
                   
                 c) 
                 4 
                 8 
                 37 
                 55 
                 70 
                 87 
                 69 
                 40 
                 24 
                 12 
                 7 
               
               
                   
               
             
          
         
       
     
     In order to evaluate the accuracy and precision attainable in Doppler angle estimation, once the flow conditions had been fixed, the probe was manually rotated until a “blind” operator estimated that the spectrogram was “symmetrical”. Then, the actual deviation from the desired 90° beam-to-vessel angle (measurement error) was evaluated through a calibrated goniometer. This procedure was repeated for different steady and pulsatile flow conditions by 4 operators, two of them not being specifically trained for this. A set of 40 measurements was thus completed producing an rms error of 0.7°. 
     The accuracy of the experiment was confirmed by taking the SI into consideration while gradually changing the Doppler angle toward 90°. It was decided that the Doppler angle could be assumed to be 90° once the SI had overcome a threshold fixed at 85%. The corresponding error was estimated by measuring, through the calibrated goniometer, how far from 90° the probe was stopped. The mean error obtained from a group of 40 measurements was confirmed to be lower than 1°. 
     Velocity measurements were performed by using the steering angles available with the Megas system. In steady flow conditions (Q=300 ml/min), the reference beam was first set at an angle θ 2  which was assumed to be 90° as soon as the SI appeared steadily &gt;85%. Then the measuring beam was steered so that interbeam angles of −18°, +12°, +18° were established. Accordingly, the velocity from the SV in the tube center was estimated, by assuming θ 1 =72°, 78°, 108°. For each interbeam angle, the measurement was repeated 5 times by holding back the probe and readjusting the M-lines orientation between successive measures. Table B summarizes these results. 
     
       
         
               
               
               
               
             
               
               
               
               
               
             
           
               
                   
                 TABLE B 
               
               
                   
                   
               
               
                   
                 72° 
                 78° 
                 108° 
               
               
                   
                 f 1  ≅ 400 Hz 
                 f 1  ≅ 500 Hz 
                 f 1  ≅ 400 Hz 
               
               
                   
                   
               
             
             
               
                   
               
             
          
           
               
                   
                 velocity 
                 26.1 
                 26.8 
                 26.0 
               
               
                   
                 [cm/s] 
                 26.2 
                 26.8 
                 25.9 
               
               
                   
                   
                 25.8 
                 26.5 
                 26.2 
               
               
                   
                   
                 26.0 
                 26.6 
                 26.5 
               
               
                   
                   
                 25.5 
                 26.4 
                 26.1 
               
               
                   
                   
               
             
          
         
       
     
     A similar test was repeated for pulsatile flow conditions (Q@200 ml/min). The behavior of velocity magnitudes obtained at 3 different steering angles is shown in  FIG. 6 , which also reports the average velocity peaks and the SDs obtained from each acquisition.