Accuracy of Doppler catheter measurements: effect of inhomogeneous beam power distribution on mean and peak velocity.

OBJECTIVES: We sought to determine the effect of inhomogeneous distribution of beam power produced by Doppler catheters on measurements of mean and peak velocity of coronary blood flow. BACKGROUND: Measurements of mean velocity of coronary blood flow by Doppler catheters have significant systematic errors that have not been completely characterized. We hypothesized that one error is the inhomogeneous distribution of the ultrasonic beam power and that this inhomogeneity makes measurements of mean, but not peak, velocity inaccurate. METHODS: We constructed a scaled-up model of a Doppler catheter to allow for accurate measurement of the distribution of beam power by miniature hydrophones. This catheter was placed in a model of coronary blood flow in which the fluid velocity was accurately measured by an external laser Doppler velocimeter. The laser Doppler measurements of mean velocity were compared with the measurements of mean velocity made by the catheter, using fast Fourier transform analysis, both without and with correction for inhomogeneous beam power distribution. Peak velocity measurements were also compared, as predicted from theory, without the need of correction for inhomogeneous beam power distribution. To investigate the clinical relevance of our results, we conducted studies using a clinical Doppler catheter both in a scaled model of coronary flow and in a series of eight patients. In the model and in each patient, we rotated the catheter without changing the axial position to systematically alter the relation of the beam power distribution to the local fluid dynamics. RESULTS: The measurement of beam power distribution revealed significant inhomogeneity. Comparison of the measured mean frequency shifts without correction for inhomogeneities in the distribution yielded a statistically significant difference. After correction for inhomogeneities, there was no statistically significant difference. Also, there was no significant difference for the peak frequency shifts. Rotation of the clinical catheter in the scaled model and in the patients changed the measured mean velocity (average change 18.8% and 20.6%, respectively), but not the measured peak velocity (average change 5.0% and 4.3%, respectively). CONCLUSIONS: For signal analysis using a fast Fourier transform, the inhomogeneous distribution of power of the ultrasonic beam produced by Doppler catheters makes measurements of mean, but not peak, velocity inaccurate. Measurements of peak velocity may therefore prove superior to measurements of mean velocity in estimating the response to pharmacologic intervention and in estimating stenosis severity.

Duke Scholars

Author Scott Jeffery Denardo Medicine, Cardiology