MEDICAL ENGNEERING SYSTMS

Doppler ultrasonic technique

Doppler ultrasound technique, was originally applied in the medical field
and dates back more then 30 years. The use of pulsed emissions has
extended this technique to other fields and has open the way to new
measuring techniques in fluid dynamics. The term "Doppler ultrasound
velocimetry" implies that the velocity is measured by finding the
Doppler frequency in the received signal, as it is the case in Laser
Doppler velocimetry. In fact, in ultrasonic pulsed Doppler velocimetry,
this is never the case. Velocities are derived from shifts in positions
between pulses, and the Doppler effect plays a minor role.
Unfortunately, many publications, even recent ones, fails to make the
distinction, resulting in erroneous system description and fallacious
interpretation of the influence from various physical effects.

Functioning principles of pulsed Doppler ultrasound

In pulsed Doppler ultrasound, instead of emitting continuous ultrasonic

waves, an emitter sends periodically a short ultrasonic burst and a
receiver collects continuously echoes issues from targets that may be
present in the path of the ultrasonic beam. By sampling the incoming
echoes at the same time relative to the emission of the bursts, the shift
of positions of scatterers are measured. Let assume a situation, as
illustrated in the figure below, where only one particle is present along
the ultrasonic beam.

From the knowledge of the time delay Td between an emitted burst and
the echo issue from the particle, the depth p of this particle could
computed by:
where c is the sound velocity of the ultrasonic wave in the liquid.If the
particle is moving at an angle q regarding the axis of the ultrasonic
beam, its velocity could be measured by computing the variation of its
depth between two emissions separated in time by Tprf:

The time difference (T2-T1) is always very short, most of the time lower
than a microsecond. It is advantageous to replace this time
measurement by a measurement of the phase shift of the received echo.

where fe is the emitting frequency. With this information the velocity of

the target is expressed by:

This last equation gives the same result as the Doppler equation. But
one should always be aware that the phenomena involved are not the
same. assume that the particles are randomly distributed inside the
ultrasonic beam. The echoes issue from each particle are then
combined together in a random fashion, giving a random echo signal.
Hopefully, a high degree of correlation exists between different
emissions. This high correlation degree is put in advance in all digital
processing techniques used in Signal Processing's Ultrasonic Doppler
velocimeter to extract information, such as the velocity.

Doppler Effect
INTODUCTION:
B-mode imaging is based on the reflection and scatter of
ultrasound at interfaces and intrinsic organic structures. The
information carriers that make Doppler sonography possible are the
red blood cells (erythrocytes) inside the vessels, which move towards
the transducer or away from it at various speed. The Doppler effect
is named after the physicist Christian Johann Doppler (1803 – 1853).
Doppler physically interpreted and mathematically expressed the
fact that the light of stars moving towards the earth undergoes a shift
towards blue (shorter wavelength), and that the light of stars moving
away from the earth undergoes a shift towards red (longer
wavelength).
In a similar way, the sound waves generated from the erythrocytes
and the echo signals returning to the transducer experience a slight
frequency shift ∆f with regard to the transmit frequency f. The
frequency shift ∆f depends on the magnitude and direction of the
blood flow velocity v. The scatter echoes from within the vessels are
weaker than the signals obtained from the interfaces of vessels,
organs, and tissues, by a factor of 100 to 1000. For their detection
and processing a very sensitive system technique is needed.

The Doppler equation (for Spectral Doppler and Color Doppler)

describes the relation between ∆f and v:

∆f = 2 ⋅ f/c ⋅ v ⋅ cos Θ

where c is the velocity of sound (at an average of 1540 m/s in tissue), v

the blood flow velocity to be analyzed and Θ the angle of incidence in
relation to the axis of the vessel. The factor 2 takes into account that
the Doppler effect is observed twice: once when the moving blood
cells receive the transmit signal from the probe, and the second time,
when the probe receives the echo from the blood cells.

The frequency shift ∆f measured by Doppler techniques – in the

following also referred to as Doppler frequency – is a direct measure
for v. For a given magnitude of v, the frequency shift ∆f will be
higher with the selection of a higher transmit frequency f.

∆f also depends on the angle of incidence: ∆f is at its highest when the

incident sound beam is directed parallel to the vessel axis. At
perpendicular incidence, cos Θ = 0, i.e., no Doppler signal is obtained.
To calculate the velocity v from the Doppler frequency ∆f, the angle
Θ must be measured in the B-mode or Color Doppler image and an
angle correction must be made.

The Doppler effect increases or reduces the echo signal frequency f

coming from the vessel by ∆f, depending on the direction of blood
flow. That means that the echo signal frequency also contains the
information on the direction of flow (bi-directional Doppler). For the
evaluation of echo signals, the flow velocities towards the transducer
are usually displayed on the positive axis in the Spectral Doppler
curve (encoded red when Color Doppler is used). They are displayed
on the negative axis and encoded blue in Color Doppler, when the
flow is directed away from the probe.

The Doppler frequencies ∆f measured within the frequency range of

2 – 10 MHz and at physiological flow velocities of several mm/s up to
1 – 2 m/s, are in the audible range between 50 Hz and 16 kHz and are
thus directly accessible to the ear as audio signals.

Advantages and limitations

The main advantage of pulsed Doppler ultrasound is its capability to

offer spatial information associated to velocity values. Unfortunately, as
the information is available only periodically, this technique suffers from
the Nyquist theorem. This means that a maximum velocity exists for
each pulse repetition frequency (Prf):
In addition to the velocity limitation, there is a limitation in depth. The
ultrasonic burst travels in the liquid at a velocity which depends on the
physical properties of the liquid. The pulse repetition frequency gives
the maximum time allowed to the burst to travel to the particle and back
to the transducer. This gives a maximum depth of:

From the above two equations, we could see that increasing the time
between pulses (TPRF) will increase the maximum measurable depth,
but will also reduce the maximum velocity which can be measured. The
maximum velocity and maximum depth are thus related according to the
following equation:
Ultrasound scattering

The ultrasonic waves generated by the transducer are more or less

confined in a narrow cone. As they travel in this cone they may be
reflected or scattered when they touch a particle having a different
acoustic impedance. The acoustic impedance is defined by:

where ρ is the density and c the sound velocity.

If the size of the particle is bigger than the wave length, the ultrasonic
waves are reflected and refracted by the particle. In such a case the
direction of propagation and the intensity of the ultrasonic waves are
affected. But if the size of the particle is much smaller than the wave
length an other phenomena appears, which is named scattering. In such
a case, a very small amount of the ultrasonic energy is reflected in all
direction. The intensity and the direction of propagation of the incoming
waves are practically not affected by the scattering phenomena.
Ultrasonic Doppler velocimetry needs therefore particles smaller than
the wave length.
Doppler Waveforms and Vascular Resistance

The velocity vs. time display of the Doppler spectrum or the velocity
curves deduced from it yield information on the differences and
changes of peripheral vascular resistance. At a constant blood
pressure P, conclusions may be drawn on the perfusion (indirect
method) from the relation between volume flow Q and vascular
resistance R (see figure 2006).

The waveform of a low resistance vessel is marked by a higher end-

diastolic flow velocity and low pulsatility. Pulsatility is defined as the
relation between systolic and end-diastolic velocity. The lower the
end-diastolic velocity, the higher is the vascular resistance.

The waveform of a high resistance vessel shows a low to disappearing

end-diastolic velocity and a high pulsatility. The triphasic flow profile
is typical of peripheral vessels in the extremities.

From the envelope curves of the Spectral Doppler, vascular resistance

and pulsatility indices can be deduced to obtain the actual vascular
resistance .
Flow Velocity and Doppler Effect

Ultrasound imaging techniques for the detection of blood flow are

based mainly on the fact that the pulses generated by the transducer
are reflected not only by motionless organ interfaces and structures
but also by the formations of red blood cells flowing in the vessels. If
it were possible to measure the spatial displacement “s” of this
formation within a time interval, e.g., the time 1 / PRF between two
pulses, the flow velocity could be calculated directly, but this direct
approach is not yet possible.

Therefore, ultrasound imaging makes use of the Doppler effect

(Christian Johann Doppler, 1803 – 1853): The frequency perceived
by an observer of light or sound traveling towards him is higher then
the perceived frequency from that same light or sound at rest. The
frequency from a source of light or sound moving away from the
observer is perceived as lower. The higher the relative velocity the
greater the difference in perceived frequencies. This frequency
difference is called Doppler frequency shift or Doppler frequency.

In ultrasound imaging, the transducer is both a “source of sound”

and an “observer”. If the flow is directed towards the transducer, i.e.,
the incident sound direction is opposite to the direction of flow (from
upper right to lower left on the graphic), the pressure wave generated
by the moving blood cells is compressed. Its wavelength is shorter
and consequently, its frequency is higher. If the flow is directed away
from the transducer (incedent sound direction from upper left to
lower right on the graphic), the echo sound wave is extended, i.e., its
frequency is lower.
The Doppler techniques in ultrasound imaging are based
upon the measurement and evaluation of the Doppler
frequency shift which, subsequently, makes it possible to
calculate the flow velocities that go with it

CW- and PW-Doppler

CW-Doppler (continuous wave) and PW-Doppler (pulsed wave) differ
in the way of signal acquisition, but have some similarities in signal
processing and presentation of results. With CW-Doppler, the
piezoceramic elements of the (phased array) transducer are divided
into two groups, one of them continuously transmitting while the
other one simultaneously receives the incoming signals. With pencil
probes, the transducer element is divided into two. Due to the
continuous operation, it is not possible to assign an echo’s point of
origin. On the other hand, very high flow velocities (e.g. a high-grade
valvular stenosis) can be analyzed unambiguously with CW-Doppler.
In simple Doppler units without duplex operation (i.e. without
support by B-mode imaging), CW-Doppler further simplifies the
detection of vessels supplied with blood.

PW-Doppler meets the requirement for measuring flow in user

selected areas of interest. One single group of array elements is used
both for receiving and transmitting. They transmit sequences of
short pulses into the body, just as in B-mode imaging. After the pulse
has traveled to the selected sample site and back (travel time T), the
sample gate is opened for a short period of time, TR, to receive the
echoes. The size and depth of the sample volume in the B-mode or the
Color Doppler image can be controlled on the monitor and are
adjustable by the sonographer.

The pulse travel time T determines the shortest possible time interval
between two successive transmit pulses. Therefore the pulse repetition
frequency PRF for the transmit pulse cannot be set higher than 1/T
without jeopardizing the unambiguous depth assignment. Since the
applicable PRF values are also in the range of the Doppler
frequencies ∆f, depth discrimination with the PW-Doppler is
achieved at the price of an ambiguous evaluation of higher flow
velocities, resulting in aliasing effects. Also Color Doppler is a PW-
technique to which both the Doppler equation and the restrictions
concerning PRF are applicable.
Direct Measurement of Volume Flow

TAV mean is equivalent to the average constant flow velocity and is the
basis for the direct, quantitative calculation of the volume flow Q:

Q = A ⋅ TAVmean

where A = π r2, the cross sectional area of the vessel at the sampling
site which is obtained from the vessel diameter 2 r measured in the B-
mode image. When interpreting these values with regard to the
volume flow Q, two critical sources of error must be considered:
First, the limited measuring accuracy of the vessel diameter,
especially in the case of very small vessels and second, the angle
correction error which depends on the angle of incidence.

Nota bene: TAVmax , i.e. the time averaged maximum velocity, cannot
be utilized for the determination of the volume flow Q, since it would
overestimate it. TAVmax is frequently used for the indirect evaluation
of organ perfusion.