WO2001033172A1 - Method of volumetric blood flow measurement - Google Patents
Method of volumetric blood flow measurement Download PDFInfo
- Publication number
- WO2001033172A1 WO2001033172A1 PCT/EP2000/010505 EP0010505W WO0133172A1 WO 2001033172 A1 WO2001033172 A1 WO 2001033172A1 EP 0010505 W EP0010505 W EP 0010505W WO 0133172 A1 WO0133172 A1 WO 0133172A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- doppler
- flow
- equation
- sample
- volumetric flow
- Prior art date
Links
- 238000000034 method Methods 0.000 title claims abstract description 19
- 230000017531 blood circulation Effects 0.000 title description 16
- 238000005259 measurement Methods 0.000 title description 11
- 238000000338 in vitro Methods 0.000 claims abstract description 4
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 3
- 238000001727 in vivo Methods 0.000 claims abstract 2
- 239000000523 sample Substances 0.000 description 27
- 238000002604 ultrasonography Methods 0.000 description 9
- 239000008280 blood Substances 0.000 description 6
- 210000004369 blood Anatomy 0.000 description 6
- XUIMIQQOPSSXEZ-UHFFFAOYSA-N Silicon Chemical compound [Si] XUIMIQQOPSSXEZ-UHFFFAOYSA-N 0.000 description 5
- 229920001296 polysiloxane Polymers 0.000 description 5
- 229910052710 silicon Inorganic materials 0.000 description 5
- 239000010703 silicon Substances 0.000 description 5
- 210000004351 coronary vessel Anatomy 0.000 description 4
- 238000010989 Bland-Altman Methods 0.000 description 3
- 238000005534 hematocrit Methods 0.000 description 3
- 238000004364 calculation method Methods 0.000 description 2
- 230000000541 pulsatile effect Effects 0.000 description 2
- 230000003595 spectral effect Effects 0.000 description 2
- 238000001228 spectrum Methods 0.000 description 2
- 238000012360 testing method Methods 0.000 description 2
- 206010020565 Hyperaemia Diseases 0.000 description 1
- 101100185024 Mus musculus Mslnl gene Proteins 0.000 description 1
- 238000000692 Student's t-test Methods 0.000 description 1
- 238000000540 analysis of variance Methods 0.000 description 1
- 238000002583 angiography Methods 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000004087 circulation Effects 0.000 description 1
- 239000013078 crystal Substances 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 230000000544 hyperemic effect Effects 0.000 description 1
- 238000002608 intravascular ultrasound Methods 0.000 description 1
- 238000012417 linear regression Methods 0.000 description 1
- 239000002245 particle Substances 0.000 description 1
- 238000012545 processing Methods 0.000 description 1
- 238000000611 regression analysis Methods 0.000 description 1
- 230000000284 resting effect Effects 0.000 description 1
- 230000005236 sound signal Effects 0.000 description 1
- 238000010561 standard procedure Methods 0.000 description 1
- 210000000779 thoracic wall Anatomy 0.000 description 1
- 238000009827 uniform distribution Methods 0.000 description 1
- 238000010200 validation analysis Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/06—Measuring blood flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/06—Measuring blood flow
- A61B8/065—Measuring blood flow to determine blood output from the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/48—Diagnostic techniques
- A61B8/488—Diagnostic techniques involving Doppler signals
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01F—MEASURING VOLUME, VOLUME FLOW, MASS FLOW OR LIQUID LEVEL; METERING BY VOLUME
- G01F1/00—Measuring the volume flow or mass flow of fluid or fluent solid material wherein the fluid passes through a meter in a continuous flow
- G01F1/66—Measuring the volume flow or mass flow of fluid or fluent solid material wherein the fluid passes through a meter in a continuous flow by measuring frequency, phase shift or propagation time of electromagnetic or other waves, e.g. using ultrasonic flowmeters
- G01F1/663—Measuring the volume flow or mass flow of fluid or fluent solid material wherein the fluid passes through a meter in a continuous flow by measuring frequency, phase shift or propagation time of electromagnetic or other waves, e.g. using ultrasonic flowmeters by measuring Doppler frequency shift
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01S—RADIO DIRECTION-FINDING; RADIO NAVIGATION; DETERMINING DISTANCE OR VELOCITY BY USE OF RADIO WAVES; LOCATING OR PRESENCE-DETECTING BY USE OF THE REFLECTION OR RERADIATION OF RADIO WAVES; ANALOGOUS ARRANGEMENTS USING OTHER WAVES
- G01S15/00—Systems using the reflection or reradiation of acoustic waves, e.g. sonar systems
- G01S15/88—Sonar systems specially adapted for specific applications
- G01S15/89—Sonar systems specially adapted for specific applications for mapping or imaging
- G01S15/8906—Short-range imaging systems; Acoustic microscope systems using pulse-echo techniques
- G01S15/8979—Combined Doppler and pulse-echo imaging systems
Definitions
- the present invention relates to a method to measure the volumetric flow in blood vessels using a pulsed Doppler instrument.
- the invention relates to an invasive method by using of a commercially available Doppler flow wire system which allows simultaneously assessment of crossectional area and mean velocity, thus providing real volumetric flow.
- the invention further relates to an non-invasive method to measure volumetric flow in the heart and in large vessels.
- volumetric blood flow is formally defined as product of mean flow velocity and corresponding vessel cross-sectional area. Accordingly, volumetric coronary blood flow can be measured by simultaneously assessing vessel size (using either quantitative angiography or intravascular ultrasound) and blood flow velocity (using intravascular Doppler). Very often, however, vessel size is not assessed and measurement of volumentric coronary blood flow relies on blood flow velocity alone, assuming that the vessel diameter remains constant during different flow conditions. Since in the assessment of coronary flow reserve (CFR; ratio of hyperemic over resting flow) it is a standard procedure to pharmacologically induce coronary hyperemia, which by definition changes coronary vessel size, this assumption is wrong.
- CFR coronary flow reserve
- Hottinger and Meindl described a noninvasive method to measure volumetric flow using a dual beam pulsed Doppler instrument.
- One sample volume intersects completely the vessel cross-section, whereas the other lays entirely within the vessel lumen.
- compensation for the effects of attenuation and scattering is achieved, and volumetric flow is obtained from the Doppler signal power.
- This method which is independent of velocity profile, vessel geometry and
- Doppler angle was later applied to an intravascular Doppler ultrasound catheter designed for intravascular measurement of volumetric blood flow.
- Doppler derived volumetric flow fig. 2: correlation between Doppler derived and reference (time-collected) flow fig. 3: Bland-Altman test fig. 4: Doppler estimated volumetric flow compared to reference blood flow given by time-collected flow in 6 silicone tubes. fig. 5: Comparison between Doppler derived flow and reference flow in 6 silicone tubes fig. 6: Relation between estimated and reference flow velocity as well as between calculated and reference cross-sectional area of the silicone tubes.
- Volume flow (Q) can be defined as a product of mean velocity (V m ) and cross sectional area (A):
- the mean flow velocity V m can be calculated as follows: If geometric and transit time spectral broadening is ignored the mean velocity within the sample volume can be obtained from the Doppler power spectrum as:
- c is the speed of sound in the medium
- f s is the emitted frequency
- f is the Doppler frequency
- S(f) is the Doppler power spectrum
- the cross sectional area (A) can be calculated as follows. From Parseval's theorem, the received Doppler power (P r ), which equals the spectral zeroth moment M 0 of the received power (15) is defined as:
- the Doppler power (P r ) received by the transducer depends on:
- V(R) A ⁇ R
- equation (5) can be rewritten as:
- sample area (A) can be calculated as shown in the next equation:
- the volumetric flow can be obtained by multiplying equation (3) with (8):
- T(R) can be calculated as follows: We propose to use a series of three consecutive sample volumes. The proximal two sample volumes are lying entirely within the vessel lumen, and their surface area A, and A 2 can be calculated either by Doppler power or trigonometrically, using ultrasound beam angle and distance between the sample volume and the tip of the Doppler flow wire. The third distal sample volume intersects completely the vessel, whereby its area A 3 has to be determined (figurel).
- the cross-sectional area A, from sample volume 1 is given by:
- M 03 is the zeroth moment of sample volume 3 at distance R 3 .
- N represents the ratio of the difference in the distance between samples 2 and 3 (i.e. R 3 - R 2 ) and that between samples 1 and 2 (i.e. R 2 - Ri) (fig. 1), or
- ⁇ (R) can be determined as follows:
- the received power per unit volume in the absence of attenuation can be represented by the scattering function
- ⁇ is a back-scattering constant for the given flow wire transcucer.
- the vessel intersecting area A 3 can be calculated as follows: From equation (14) the vessel intersecting area of the third sample volume can be given as
- the cross-sectional areas Ai and A 2 can be calculated from the distance to the transducer (R) and the ultrasound beam angle. For the two sample volumes, lying entirely within the vessel lumen the cross-sectional area of the beam at the distance R can be written approximately as:
- A ⁇ (Rtana (18) where ⁇ is half the angle of the ultrasound beam.
- the situation of N>1 is important for the transthoracic 2D approach as the 2D-Doppler probe is fixed extracorporally (chest wall) whereas the structure of interest (vessel or chamber) is moving (heart beat). To ascertain that only A 3 always intersects the structure of interest but Ai and A 2 do not intersect despite the movement of the heart. The distance between A 2 and A 3 must be adjustable by increasing N.
- a 2D Doppler-Echo Instrument and using equation 19 whereby N>1 and to broaden the beam in the lateral and elevation dimension the elements of the transducer are turned off and/or a lens in front of the transducer is mounted.
- Doppler guidewire and momentum measurements may be used a 2D Doppler-Echo Instrument and using equation 19 whereby N>1 and to broaden the beam in the lateral and elevation dimension the elements of the transducer are turned off and/or a lens in front of the transducer is mounted.
- the Doppler flow wire (FloWire®, Cardiometrics, Mountain View, CA) is a torquable, guidable wire with a nominal diameter of 0.35 mm and a length of 175 cm, which is capable of entering small and distal branches of the coronary tree.
- a 12 MHz piezoelectric crystal is mounted at the tip of the guidewire.
- the forward directed ultrasound beam diverges ⁇ 13° from its axis as measured (by the manufacturer) at the - 6 dB points of the ultrasonic beam pattern (two-way beam width).
- the Doppler guidewire is coupled to a commercially available Doppler system (FloMap®, Cardiometrics, Mountain View, CA). The gain and filter settings were held constant throughout the study.
- the Doppler system calculates and displays several variables on-line, including the time average peak velocity (APV), zeroth (M 0 ) and first (M,) Doppler moment, and mean flow velocity as well as average peak velocity (APV).
- AAV time average peak velocity
- M 0 zeroth
- M first
- API mean flow velocity
- the sample volume depth of the sample volume can be moved along the beam axis at discrete steps of 0.13 mm as determined by the manufacturer.
- the Doppler guidewire was inserted into the silicon tubes and placed at a position where a fully developed flow profile would be expected. Special care was taken for optimal positioning of the Doppler guidewire to ensure that the samle volume is placed in the center of the vessel in order to insonate most of the cross-sectional area.
- ⁇ mass density
- a vessel radius
- v velocity
- ⁇ viscosity
- the critical entrance length (X) was calculated according to Caro et al. (Caro C.G.: Pedley, T.J.; Schroter, W.A.; The mechanics of the Circulation; New York; Oxford University Press; 1978).
- the positioning of the sample volume 3 plays a key role as the size of the interrogated vessel is unknown.
- the first step consists in assessing the gate depth at which the sample volume completely intersects the vessel. As shown in figure 1 , a series of only 3 sample volumes is required. The following conditions must be satisfied:
- the mean differences between the two flow estimations following Bland-Altman was 2.4 ⁇ 0.5 ml/min, ns, for a mean flow of 54 ml/min, ranging from 10 to 200 ml/min.
- the mean flow differences in the individual tubes were as follows: tube 1.5 mm - 2.4 ⁇ 0.5 ml/min, tube 2.0 mm - 2.4+0.5 ml/min, tube 2,5 mm - 2.4 ⁇ 0.5 ml/min, tube 3.0 mm -2.4 ⁇ 0.5 ml/min, tube 3.5 mm - 2.4 ⁇ 0.5 ml/min, and tube 4.0 mm - 2.4 ⁇ ml/min, all ns.
Abstract
Description
Claims
Priority Applications (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002389363A CA2389363A1 (en) | 1999-10-29 | 2000-10-25 | Method of volumetric blood flow measurement |
AU11446/01A AU1144601A (en) | 1999-10-29 | 2000-10-25 | Method of volumetric blood flow measurement |
EP00972865A EP1224436A1 (en) | 1999-10-29 | 2000-10-25 | Method of volumetric blood flow measurement |
JP2001535009A JP2003512913A (en) | 1999-10-29 | 2000-10-25 | How to measure blood volume flow |
US10/111,944 US6601459B1 (en) | 1999-10-29 | 2000-10-25 | Method of volumetric blood flow measurement |
US10/138,910 US20020157297A1 (en) | 1999-11-05 | 2002-05-03 | Anchoring element for a firearm |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
ATA1828/99 | 1999-10-29 | ||
AT182899 | 1999-10-29 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/138,910 Continuation US20020157297A1 (en) | 1999-11-05 | 2002-05-03 | Anchoring element for a firearm |
Publications (1)
Publication Number | Publication Date |
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WO2001033172A1 true WO2001033172A1 (en) | 2001-05-10 |
Family
ID=3521873
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2000/010505 WO2001033172A1 (en) | 1999-10-29 | 2000-10-25 | Method of volumetric blood flow measurement |
Country Status (6)
Country | Link |
---|---|
US (1) | US6601459B1 (en) |
EP (1) | EP1224436A1 (en) |
JP (1) | JP2003512913A (en) |
AU (1) | AU1144601A (en) |
CA (1) | CA2389363A1 (en) |
WO (1) | WO2001033172A1 (en) |
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WO2003032556A2 (en) | 2001-10-10 | 2003-04-17 | Team Medical, Llc | Method and system for obtaining dimension related information for a flow channel |
WO2009031034A2 (en) * | 2007-08-10 | 2009-03-12 | Norwegian University Of Science And Technology | Methods and devices for estimating blood flow characteristics |
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Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
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US4067236A (en) * | 1975-11-10 | 1978-01-10 | Univ Leland Stanford Junior | Method and system for unambiguous method of volume flow |
US4257278A (en) * | 1979-08-24 | 1981-03-24 | General Electric Company | Quantitative volume blood flow measurement by an ultrasound imaging system featuring a Doppler modality |
US4493216A (en) * | 1981-11-27 | 1985-01-15 | Siemens Aktiengesellschaft | Method and apparatus for conducting flow measurements on flowing media according to the ultrasonic doppler method |
US5174295A (en) * | 1987-04-10 | 1992-12-29 | Cardiometrics, Inc. | Apparatus, system and method for measuring spatial average velocity and/or volumetric flow of blood in a vessel and screw joint for use therewith |
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US4259870A (en) * | 1979-02-26 | 1981-04-07 | Howmedica Inc. | Doppler method of measuring flow |
US4519260A (en) * | 1982-02-18 | 1985-05-28 | The Board Of Trustees Of The Leland Stanford Junior University | Ultrasonic transducers and applications thereof |
US4431936A (en) * | 1982-02-18 | 1984-02-14 | The Board Of Trustees Of The Leland Stanford Junior University | Transducer structure for generating uniform and focused ultrasonic beams and applications thereof |
US4807636A (en) * | 1986-09-09 | 1989-02-28 | Vital Science Corporation | Method and apparatus for measuring volume fluid flow |
-
2000
- 2000-10-25 EP EP00972865A patent/EP1224436A1/en not_active Withdrawn
- 2000-10-25 AU AU11446/01A patent/AU1144601A/en not_active Abandoned
- 2000-10-25 US US10/111,944 patent/US6601459B1/en not_active Expired - Fee Related
- 2000-10-25 CA CA002389363A patent/CA2389363A1/en not_active Abandoned
- 2000-10-25 JP JP2001535009A patent/JP2003512913A/en active Pending
- 2000-10-25 WO PCT/EP2000/010505 patent/WO2001033172A1/en not_active Application Discontinuation
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4067236A (en) * | 1975-11-10 | 1978-01-10 | Univ Leland Stanford Junior | Method and system for unambiguous method of volume flow |
US4257278A (en) * | 1979-08-24 | 1981-03-24 | General Electric Company | Quantitative volume blood flow measurement by an ultrasound imaging system featuring a Doppler modality |
US4493216A (en) * | 1981-11-27 | 1985-01-15 | Siemens Aktiengesellschaft | Method and apparatus for conducting flow measurements on flowing media according to the ultrasonic doppler method |
US5174295A (en) * | 1987-04-10 | 1992-12-29 | Cardiometrics, Inc. | Apparatus, system and method for measuring spatial average velocity and/or volumetric flow of blood in a vessel and screw joint for use therewith |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2003032556A2 (en) | 2001-10-10 | 2003-04-17 | Team Medical, Llc | Method and system for obtaining dimension related information for a flow channel |
EP1450679A2 (en) * | 2001-10-10 | 2004-09-01 | Team Medical, L.L.C. | Method and system for obtaining dimension related information for a flow channel |
EP1450679A4 (en) * | 2001-10-10 | 2008-04-09 | Team Medical Llc | Method and system for obtaining dimension related information for a flow channel |
AU2002359256B2 (en) * | 2001-10-10 | 2009-01-08 | Team Medical, Llc | Method and system for obtaining dimension related information for a flow channel |
WO2009031034A2 (en) * | 2007-08-10 | 2009-03-12 | Norwegian University Of Science And Technology | Methods and devices for estimating blood flow characteristics |
WO2009031034A3 (en) * | 2007-08-10 | 2009-06-18 | Norwegian University Of Scienc | Methods and devices for estimating blood flow characteristics |
Also Published As
Publication number | Publication date |
---|---|
AU1144601A (en) | 2001-05-14 |
EP1224436A1 (en) | 2002-07-24 |
JP2003512913A (en) | 2003-04-08 |
CA2389363A1 (en) | 2001-05-10 |
US6601459B1 (en) | 2003-08-05 |
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