Validation of a Doppler guide wire for intravascular measurement of coronary artery flow velocity.

BACKGROUND: An improved intravascular ultrasonic Doppler device could aid the clinical assessment of coronary hemodynamics. We evaluated a new device consisting of a 12-MHz piezoelectric transducer integrated onto the tip of a 0.018-in. flexible, steerable angioplasty guide wire. METHODS AND RESULTS: Doppler spectra were recorded in model tubes with pulsatile blood flow and in-line electromagnetic flowmeter. In four straight tubes (i.d., 0.79-4.76 mm), the time average of spectral peak velocity (APV) was linearly related to blood flow (QEMF) (r2 greater than or equal to 0.98 for each tube). A Doppler-derived quantitative flow estimate (QD) was calculated as the product of vessel cross-sectional area and mean velocity, with mean velocity estimated as 0.5 x APV. The slope of QD versus QEMF for the four tubes was near unity. APV was less accurate in a 7.94-mm straight tube and in tortuous segments. In four dogs, the left circumflex coronary artery (LCx) was perfused from the femoral artery via a cannula with in-line electromagnetic flowmeter. Good-quality signals were obtained in proximal and distal LCx vessels 3.3-1.2 mm in diameter. APV varied linearly with QEMF (r2 greater than or equal to 0.99 in the cannula, r2 = 0.93-0.99 in proximal LCx, and r2 = 0.86-0.99 in distal LCx). QD was calculated by quantitative angiography to determine proximal LCx diameter. For all dogs combined, the slope of QD versus QEMF was 0.95 in the cannula and 0.85 in the proximal LCx. CONCLUSIONS: The Doppler guide wire measures phasic flow velocity patterns and linearly tracks changes in flow rate in small, straight coronary arteries. It should facilitate measurement of phasic coronary flow velocity during coronary angiography and angioplasty.

A digital annular array prototype scanner for realtime ultrasound imaging.

The use of annular array transducers in diagnostic ultrasound applications is growing. The development of this equipment raises a number of questions concerning both the role these systems will play in the clinic and how the annular array can be best implemented in an ultrasound scanner. In this paper, we will build on the results of the previous companion paper to describe the development of a 12 element 30 mm diameter 4.5 MHz laboratory prototype scanner. The mechanical probe and probe acoustics are discussed and a unique digital receive beamformer (DRB) and signal processor are described. Focusing down to an f-number (focal length/diameter) of 0.9 is demonstrated. Measured angular beamwidths of 0.62 degrees at -6 dB and 2.8 degrees at -50 dB are in good agreement with theoretical predictions. Images of phantoms and normal volunteers showed exceptional resolution with little variation in the fine speckle texture as a function of depth. The effect of the number of transmit focal zones on image quality is demonstrated.