Real-Time Blood Pressure Estimation From Force-Measured Ultrasound.

OBJECTIVE: Our objective is to create a blood pressure measurement device, which may provide a way to easily acquire frequent measurements. Common techniques to measure blood pressure include an arterial catheter, an oscillometric pressure cuff, or an auscultatory pressure cuff. METHODS: The approach takes as input ultrasound images of an artery and contact force between the ultrasound array and subject. A subject may perform the self-measurements. Image and force data is analyzed for its quality and used to provide guidance or reject poor measurements. Tissue motions, due to probe contact forces and pulsing blood pressure, are estimated from the ultrasound image. Tissues elasticities and blood pressure are found by optimally fitting the observed tissue motion versus applied forces to a table of predicted motion-pre-generated with a finite element tissue deformation model. The output of the optimization is an estimate of systolic and diastolic blood pressure, arterial stiffness, and surrounding tissue stiffness. RESULTS: The real-time implementation of the algorithm was validated on a cohort of 21 single-visit volunteers and on four volunteers self-monitored longitudinally. The systolic and diastolic pressures were compared to oscillometric cuff readings. Regression and Bland-Altman analyses were performed. CONCLUSION: Systolic pressure and diastolic pressure can be estimated in real-time and by the subject using this novel non-invasive ultrasound-based method (systolic accuracy/precision: -5.2 mmHg/10.7 mmHg; diastolic accuracy/precision: -3.9/8.0 mmHg). SIGNIFICANCE: The method occupies a middle ground between the arterial catheter and cuff-based techniques. It has the potential to give calibration-free results.

Noninvasive Blood Pressure Estimation Using Ultrasound and Simple Finite Element Models.

OBJECTIVE: Many commercially available arterial blood pressure measurement devices suffer from a range of weaknesses. For example, common weaknesses include being inaccurate, invasive, and ad hoc; many also require explicit user calibration or cut off blood flow to a limb. A novel algorithmic approach is presented to accurately estimate systolic and diastolic blood pressure in a way that does not require any explicit user calibration, is noninvasive, and does not cut off blood flow. METHODS: The approach uses ultrasound images of the arterial wall and corresponding contact force data to obtain blood pressure estimates. To acquire data, an ultrasound probe was placed on the patient's carotid artery and the contact force was increased from 1.5 to 12 N. The artery was then algorithmically segmented from the recorded DICOM B-Mode data. The segmentation data and the contact force were used as input into the Levenberg-Marquardt optimization method to solve for the parameters, including blood pressure, of a simple finite element model of the carotid artery. RESULTS: The algorithm was validated on 24 healthy volunteers. Algorithm arterial blood pressure predictions were compared to oscillometric blood pressure cuff readings. Regression and Bland-Altman analyses were performed on the data. CONCLUSION: Both systolic pressure and diastolic pressure can be estimated using this novel noninvasive ultrasound-based method (systolic accuracy/precision: $-$ 2.36 mmHg/10.21 mmHg; diastolic accuracy/precision: $-$ 0.32/8.23 mmHg). SIGNIFICANCE: The method occupies a clinical middle ground between the arterial catheter and cuff-based techniques. It has the potential to give accurate results for patients with hypertension and atherosclerosis.

Arterial blood pressure estimation using ultrasound: Clinical results on healthy volunteers and a medicated hypertensive volunteer.

This study presents a non-occlusive and non-invasive ultrasound-based technique to measure blood pressure. Most popular clinically-used arterial blood pressure measurement techniques suffer from important weaknesses including being inaccurate, invasive, or occlusive. In the proposed technique, an ultrasound probe is placed on the patient's carotid artery and the contact force between the probe and the tissue is slowly increased while ultrasound images and contact force data are recorded. From this data, the artery is segmented and the segmentation data is sent into an optimization procedure; after post-processing, blood pressure is displayed to the user. This technique was applied to 24 healthy single-visit volunteers, one multi-visit healthy volunteer, and one multi-visit medicated hypertensive volunteer. Compared to the oscillometric cuff, the accuracy and precision of the algorithm-reported systolic pressure is -2.4 ± 10.2 mmHg, and for diastolic pressure is -0.3 ± 8.2 mmHg. This method has the potential to occupy a clinical middle-ground between the arterial catheter and the oscillometric cuff.

Multi-frame elastography using a handheld force-controlled ultrasound probe.

We propose a new method for strain field estimation in quasi-static ultrasound elastography based on matching RF data frames of compressed tissues. The method benefits from using a handheld force-controlled ultrasound probe, which provides the contact force magnitude and therefore improves repeatability of displacement field estimation. The displacement field is estimated in a two-phase manner using triplets of RF data frames consisting of a pre-compression image and two post-compression images obtained with lower and higher compression ratios. First, a reliable displacement field estimate is calculated for the first post-compression frame. Second, we use this displacement estimate to warp the second post-compression frame while using linear elasticity to obtain an initial approximation. Final displacement estimation is refined using the warped image. The two-phase displacement estimation allows for higher compression ratios, thus increasing the practical resolution of the strain estimates. The strain field is computed from a displacement field using a smoothness- regularized energy functional, which takes into consideration local displacement estimation quality. The minimization is performed using an efficient primal-dual hybrid gradient algorithm, which can leverage the architecture of a graphical processing unit. The method is quantitatively evaluated using finite element simulations. We compute strain estimates for tissue-mimicking phantoms with known elastic properties and finally perform a qualitative validation using in vivo patient data.

Quantitative elastography and its application to blood pressure estimation: theoretical and experimental results.

Elastography is a method that can be used to measure the elasticity of soft biological tissue and, ultimately, to detect cancerous tumors. In this paper, quantitative elastography is developed using a fast multi-scale approach. Results are presented in simulation and preliminary results are presented in experiment. The optimization methods of elastography are applied to measure noninvasively the arterial wall stiffness of a vessel as well as blood pressure. Simulation results are presented that confirm the accuracy of methods, and preliminary experimental results are presented that measure pressure within a cylindrical cavity in a phantom. Using ultrasound, these methods could provide noninvasive continuous measurement of blood pressure in major arteries and could give doctors another method with which to gather information about a patient's cardiovascular health.

Natural frequencies of two bubbles in a compliant tube: analytical, simulation, and experimental results.

Motivated by various clinical applications of ultrasound contrast agents within blood vessels, the natural frequencies of two bubbles in a compliant tube are studied analytically, numerically, and experimentally. A lumped parameter model for a five degree of freedom system was developed, accounting for the compliance of the tube and coupled response of the two bubbles. The results were compared to those produced by two different simulation methods: (1) an axisymmetric coupled boundary element and finite element code previously used to investigate the response of a single bubble in a compliant tube and (2) finite element models developed in comsol Multiphysics. For the simplified case of two bubbles in a rigid tube, the lumped parameter model predicts two frequencies for in- and out-of-phase oscillations, in good agreement with both numerical simulation and experimental results. For two bubbles in a compliant tube, the lumped parameter model predicts four nonzero frequencies, each asymptotically converging to expected values in the rigid and compliant limits of the tube material.