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P R Hoskins

Publications and source records attributed to P R Hoskins.

At least 19 recordsLinked to original sources

Design and characterisation of a wall motion phantom.

Arterial wall motion is an essential feature of a healthy cardiovascular system and it is known that wall motion is affected by age and disease. In recent years, methods have been developed for measurement of wall motion with the intention of providing diagnostically useful information. An issue with all of these techniques is the accuracy and variability of both wall motion and derived quantities such as elasticity, which requires the development of suitable test tools. In this paper, a vessel wall phantom is described for use in ultrasound studies of wall motion. The vessel was made from polyvinyl alcohol (PVA) subjected to a freeze-thaw process to form a cryogel (PVA-C). The elastic modulus, acoustic velocity and attenuation coefficient varied from 57 kPa, 1543 m s(-1) and 0.18 dB cm(-1) MHz(-1) for one freeze-thaw cycle to 330 kPa, 1583 m s(-1) and 0.42 dB cm(-1) MHz(-1) for 10 freeze-thaw cycles. Wall motion was effected by the use of pulsatile flow produced from a gear pump. The use of a downstream flow resistor removed gross distortions in the wall motion waveform, possibly by removal of reflected pressure waves. However, a low amplitude 20 Hz oscillation remained, which is unphysiologic and thought to be caused by the vibration of the distended PVA-C vessel.

Arteries↗

Angle-dependence and reproducibility of dual-beam vector doppler ultrasound in the common carotid arteries of normal volunteers.

Dual-beam vector Doppler has the potential to improve peak systolic blood velocity measurement accuracy by automatically correcting for the beam-flow Doppler angle. Using a modified linear-array system with a split receive aperture, we have assessed the angle-dependence over Doppler angles of 40 degrees -70 degrees and the reproducibility of the dual-beam blood maximum velocity estimate measured in the common carotid arteries (CCA) 1 to 2 cm prior to the bifurcation of 9 presumed-healthy volunteers. The velocity magnitude estimate was reduced by approximately 7.9% as the angle between the transmit beam and the vessel axis was increased from 40 degrees to 70 degrees. With repeat measurements made, on average, approximately 6 weeks apart, the 95% velocity magnitude limits of agreement were as follows: Intraobserver -41.3 to +45.2 cm/s; interobserver -29.6 to +46.8 cm/s. There was an 8.6 cm/s interobserver bias in velocity magnitude. We conclude that the dual-beam vector Doppler system can measure blood velocity within its scan plane with low dependence on angle and with similar reproducibility to that of single-beam systems.

Adult↗

Assessment of the acoustic properties of common tissue-mimicking test phantoms.

Ultrasound (US) test phantoms incorporating tissue-mimicking materials (TMMs) play an important role in the quality control (QC) and performance testing of US equipment. Three commercially available TMMs (Zerdine from CIRS Inc.; condensed-milk-based gel from Gammex RMI; urethane-rubber-based from ATS Labs) and a noncommercial agar-based TMM, were investigated. Acoustic properties were measured over the frequency range 2.25 to 15 MHz at a range of ambient temperatures (10 to 35 degrees C). The acoustic velocity of the TMMs remained relatively constant with increasing frequency. Only the agar-based TMM had a linear increase of attenuation with frequency, with the other materials exhibiting nonlinear responses to varying degrees (f(1.08) to f(1.83)). The acoustic velocity and attenuation coefficient of all the TMMs varied with temperature, with the urethane-rubber TMM showing the greatest variation of +/- 1.2% for acoustic velocity and +/- 12% for attenuation coefficient. The data obtained in this study highlight the importance of greater knowledge of the acoustic behavior of TMMs to variations in both frequency and temperature, to ensure that accurate and precise measurements are obtained during QC and performance testing.

Gels↗

Ultrasound techniques for measurement of blood flow and tissue motion.

This article will review the ability of ultrasound techniques to provide 3D information on arterial geometry, blood flow and tissue motion.3D systems. 3D datasets can be obtained by sequential acquisition of 2D slices. Ideally a transducer is required in which there is full control of beam steering within a 3D volume. This requires a 2D array consisting of several thousand elements. Prototype 2D arrays have been built which provide several 3D datasets per second. Blood velocity measurement. Current Doppler systems estimate only the component of velocity in the direction of the Doppler beam. Lack of knowledge of the direction of blood motion and also other effects associated with 'spectral broadening' limit the accuracy of velocity measurement. Improved accuracy can be obtained using vector Doppler systems using 2 or 3 beam directions; this approach is referred to as 'vector Doppler'. Tissue motion. Doppler techniques can also be used to detect tissue motion (Tissue Doppler Imaging or TDI). Motion of the artery wall can be calculated from the TDI images. It is possible to estimate simultaneously motion for adjacent diameters within the longitudinal plane, and to visualise the relative motion at different parts of the wall.

Arteries↗

MRI measurement of wall shear stress vectors in bifurcation models and comparison with CFD predictions.

Steady fluid flow was studied in a simple bifurcation model and in a physiologically realistic model of the human carotid bifurcation. Wall shear stress (WSS) vectors were calculated from phase-contrast (PC) magnetic resonance imaging (MRI) measurements of the velocity field. Velocity measurements in the inflow regions were also used as boundary conditions for computational fluid dynamics (CFD) calculations of WSS, which were compared with those derived from MRI alone. In regions of well-behaved flow, MRI and CFD estimates of WSS were in good general agreement. In regions of disturbed flow, for example near the bifurcation, the quality of the MRI measurements was sufficient for reliable calculation of WSS vectors when a sensitive surface coil was used. The combination of MRI and CFD would seem to be a powerful technique for the investigation of flow phenomena.

Blood Flow Velocity↗

Construction and geometric stability of physiological flow rate wall-less stenosis phantoms.

Wall-less flow phantoms are preferred for ultrasound (US) because tissue-mimicking material (TMM) with good acoustical properties can be made and cast to form anatomical models. The construction and geometrical stability of wall-less TMM flow phantoms is described using a novel method of sealing to prevent leakage of the blood-mimicking fluid (BMF). Wall-less stenosis flow models were constructed using a robust agar-based TMM and sealed using reticulated foam at the inlet and outlet tubes. There was no BMF leakage at the highest flow rate of 2.8 L/min in 0%, 35% and 57% diameter reduction stenoses models. Failure of the 75% stenosis model, due to TMM fracture, occurred at maximum flow rate of 2 L/min (mean velocity 10 m/s within the stenosis). No change of stenosis geometry was measured over 4 days. The construction is simple and effective and extends the possibility for high flow rate studies using robust TMM wall-less phantoms.

Acoustics↗

Quantitative analysis of PC MRI velocity maps: pulsatile flow in cylindrical vessels.

The accuracy of MR phase contrast (PC) velocity mapping, and the subsequent derivation of wall shear stress (WSS) values, has been quantitatively assessed. Using a retrospectively gated PC gradient-echo technique, the temporal-spatial velocity fields were measured for pulsatile flow in a rigid cylindrical vessel. The experimental data were compared with values derived from the Womersley solution of the Navier-Stokes equations. For a sinusoidal waveform, the overall root-mean-square (rms) difference between the measured and analytical velocities corresponded to 13% of the peak fluid velocity. The WSS derived from the data displayed a 14% rms difference with the analytical model. As an example of a more complicated flow, a triangular saw-tooth waveform was deconstructed into its Fourier components. Velocity maps and the WSS were calculated by the superposition of the individual solutions, weighted by the Fourier series coefficient, for each harmonic. The velocity and experimentally derived WSS agreed with the analytical results (4% and 12% rms difference, respectively). Evaluation of the analytical models allowed an estimate of the inherent accuracy in the measurement of velocity maps and WSS values.

Arteriosclerosis↗

The relationship between abdominal aortic aneurysm distensibility and serum markers of elastin and collagen metabolism.

BACKGROUND: abdominal aortic aneurysm (AAA) distensibility may be an independent predictor of growth and rupture, possibly because it reflects changes in aortic wall structure and composition. AIM: to determine whether AAA distensibility is related to circulating markers of elastin and collagen metabolism. METHODS: sixty-two male patients of median age (IQR) 68 (65-72) years with asymptomatic AAA of median (IQR) diameter 42 (37-45) mm were prospectively studied. Pressure-strain elastic modulus (Ep) and stiffness (beta) were measured using an ultrasonic echo-tracker (Diamove). Serum elastin peptides (SEP), plasma elastin-alpha1-antitrypsin complex (E-AT), procollagen III-N-terminal propeptide (PIIINP) were measured by enzyme-linked immunoassay. RESULTS: age and smoking adjusted Ep and beta were significantly inversely related to SEP (r=-0.33 and r=-0.31 respectively, both p<0.02) and E-AT (r=-0.27 and r=-0.27 respectively, both p<0.05) both of which indicate elastolysis. By contrast, there was a significant positive correlation between PIIINP, indicative of increased collagen turn-over, and both Ep and beta (both r=0.45, p<0.01 unadjusted correlations). CONCLUSION: increased elastolysis is associated with increased AAA wall distensibility; whereas increased collagen turn-over is associated with reduced distensibility.

Adult↗

Comparison of brachial artery pressure and derived central pressure in the measurement of abdominal aortic aneurysm distensibility.

OBJECTIVE: AAA distensibility (Ep, beta) may predict growth and risk of rupture. However, distensibility measurements based on brachial rather than central pressure may be inaccurate. Our aim was to compare AAA distensibility using non-invasive brachial and derived central aortic pressure. DESIGN: brachial and central pressures were measured prospectively by automated sphygmomanometry (Omron) and pulse wave analysis (SphygmoCor) respectively. AAA distensibility was calculated using brachial (Ep(b), beta(b)) and central (Ep(c), beta(c)) pressures by ultrasonic echo-tracking (Diamove). Twenty-eight patients (18 males) were selected on a first come basis from a larger study of AAA patients. There were no exclusion criteria, so 54% had cardiac dysfunction (MI, angina) and 14% were hypertensive (BP >140/90 mmHg). RESULTS: median (IQR) age was 74 (70-77) years, median AAA (IQR) diameter was 44 (40-51) mm. Central and brachial systolic pressures were significantly different, [140 (121-153) vs 144 (130-164) mmHg respectively, p < or =0.01]. Central and brachial diastolic pressures were not significantly different [76 (72-86) vs 76 (71-86) mmHg respectively, p=0.5]. Ep(c)(3.0, [2.2-4.9]) and beta(c)(22.2 [15.5-33.2]) were significantly lower than Ep(b)(3.6, [2.4-5.1] 10(5)Nm(-2)) and beta(b)(24.7 [17.1-33.0] a.u., all p < 0.001. Brachial and central derived distensibility remained significantly different after adjusting for age and diameter (p<0.001). CONCLUSION: the use of brachial pressure leads to a small, systematic overestimate of Ep (18%) and beta (11%) independent of age and AAA diameter. This systematic error will not bias follow-up of changes in distensibility.

Aged↗

Ultrasonic measurement of abdominal aortic aneurysm wall compliance: a reproducibility study.

PURPOSE: The purpose of this study was to examine the intraobserver and interobserver error associated with ultrasonic echo-tracking compliance measurement in patients with abdominal aortic aneurysm. METHODS: Two observers independently measured brachial blood pressure by sphygmomanometer and maximum aortic diameter, pressure strain elastic modulus (Ep) and stiffness using an ultrasonic echo-tracker. The observer was blind to several variables: pulse pressure, diameter change, Ep, and stiffness. In study 1, observer A measured compliance in 13 patients at 30 to 60 minutes apart. In study 2, observers A and B each measured compliance on 23 patients at two visits, 2 weeks apart. RESULTS: There were no significant differences within observer A's compliance measurements. The coefficients of variation of method error (CV(ME)) for directly measured variables were systolic blood pressure, 7.3%; diastolic blood pressure, 5.4%; and maximum aortic diameter, 2.6%. CV(ME) values for derived variables were Ep, 21.2%, and stiffness, 17.6%. No differences were found between observers A and B and visits 1 and 2. CV(ME) values were 7.9% or less for directly measured variables and 32.7% or less for derived variables. These CV(ME) values were greatly reduced when the calculation was made with the use of log transformed data. CONCLUSION: The high CV(ME) value for derived variables is largely due to their wide variation within this population. This technique can measure abdominal aortic aneurysm diameter and compliance with an acceptable level of intraobserver and interobserver error.

Aorta, Abdominal↗

Doppler backscatter properties of a blood-mimicking fluid for Doppler performance assessment.

The Doppler backscatter properties of a blood-mimickig fluid (BMF) were studied to evaluate its suitability for use in a Doppler flow test object. Measurements were performed using a flow rig with C-flex tubing and BMF flow produced by a roller pump or a gear pump. A SciMed Doppler system was used to measure the backscattered Doppler power with a root-mean-square power meter connected to the audio output. Studies investigated the dependence of the backscattered Doppler power of the BMF with: circulation time; batch and operator preparations; storage; sieve size; flow speed; and pump type. A comparison was made with human red blood cells resuspended in saline. The backscatter properties are stable and within International Electrotechnical Commission requirements. The BMF is suitable for use in a test object for Doppler performance assessment.

Blood↗

Finite beam-width ray model for geometric spectral broadening.

The purpose of the study was to compare measured spectral width and maximum frequency with that predicted from ray models of geometric spectral broadening. Zero and finite beam-width models were used. Spectral data were acquired from a string phantom using two commonly-used linear array systems. Beam width and Doppler aperture sizes were measured using a needle hydrophone. The results showed that the experimentally measured data agreed best with the finite beam-width model. The zero beam-width model was in error by up to 50% for calculated spectral width, and up to 10% for maximum frequency. It is concluded that spectral width and maximum frequency are best calculated using the finite beam-width model, and that ultrasound manufacturers could improve the variation in spectral broadening measured at different locations on a single machine by adjusting the aperture size to give a constant subtended angle and beam width.

Models, Theoretical↗

A comparison of single- and dual-beam methods for maximum velocity estimation.

The purpose of this study was to compare the precision and accuracy of maximum velocity estimation when the target direction is known (a string phantom), and when the target direction is unknown (a flow model of arterial stenosis with stenoses of 0-80% by area). Maximum velocity was estimated using single- and dual-beam methods. A linear-array system was used to acquire Doppler spectra from a single-beam direction. The same array was used for sequential acquisition of Doppler spectra from 2 beam directions; the velocity estimates from these were then compounded in a vector manner. The variation of estimated maximum velocity with beam-string angle over the range 40-80 degrees was 27% for conventional Doppler, 2.6% for angle correction from the edge of the array and 1.6% for the vector Doppler. In the stenosis model, for the single-beam methods, the highest frequency shift was obtained just prior to the point of minimum lumen. At this location, the variation with beam-vessel angle over the range 40-80 degrees was 35% for conventional Doppler, 7.4% for the correction factor method and 6.9% for correction from the edge of the array. For the vector method, the maximum velocity is obtained from within the poststenotic jet, the variation was 2% over the range 40-80 degrees. It is recommended that existing Doppler systems use the correction-factor method to reduce variation in measured maximum velocity. The use of the vector technique by future generations of Doppler systems may lead to angle-independent velocity estimation.

Arterial Occlusive Diseases↗

A review of the measurement of blood velocity and related quantities using Doppler ultrasound.

Ultrasound systems can be used to investigate blood flow by use of the Doppler effect. The flow information may be displayed as either a real-time sonogram or a two-dimensional colour image. Estimates of maximum velocity using commercial systems are in error by typically 10-100 per cent; this is associated with the inability of the single-beam Doppler method to measure the true direction of flow, and with geometric spectral broadening. Vector Doppler systems acquire Doppler information along two beam directions and are able to measure accurately the velocity and direction of motion within the scan plane. The small beam width of modern Doppler systems means that the condition of uniform insonation, required for estimation of mean velocity from mean frequency shift, is not valid except for the very smallest vessels. Other quantities related to the velocity may also be estimated, such as the volumetric flow and wall shear stress. Flow visualization using colour flow imaging suffers from dependence of the displayed colour on the direction of blood motion. The vector Doppler technique may be extended to colour flow to give improved visualization of flow, in which there is no angle dependence within the scan plane.

Blood↗

Developments in cardiovascular ultrasound. Part 2: Arterial applications.

Many of the changes resulting from arterial disease can be measured, using Doppler ultrasound for measurement of blood velocity and B-scan imaging for measurement of tissue structure and composition. Wall thickness, the degree of arterial narrowing and plaque volume can be measured using B-scan imaging, and 3D ultrasound can be used to improve the accuracy of measurements of plaque volume and for improved visualisation of complex arterial geometries. Measurement of the dynamic properties of the arterial wall permits estimation of wall elasticity and plaque motion. From the Doppler signal, measurements of blood velocity are used to estimate the degree of arterial narrowing and volumetric flow, although measurement errors can be large. Wall shear stress can be estimated by measuring the velocity gradient at the vessel wall. The problems of inadequate spatial resolution and interference from overlying tissue are largely removed when intravascular systems are used, and these have superior capability in the assessment of arterial structure and tissue composition. However, measurement of quantities relating to blood flow is more difficult using the intravascular approach, as the indwelling cather disturbs the blood flow pattern, and currently, assessment of flow and vessel cross-section are not performed at the same site.

Arterial Occlusive Diseases↗

Developments in cardiovascular ultrasound. Part 3: Cardiac applications.

Echocardiography is still the principal, non-invasive method of investigation for the evaluation of cardiac disorders. Using Doppler ultrasound, indices such as coronary flow reserve and cardiac output can be determined. The severity of valvular stenosis can be determined by the area of the valve, either directly from 2D echo, from pressure half-time calculations, from continuity equations or from the proximal isovelocity surface area method. Alternatively, the severity of regurgitation can be estimated by colour or pulsed ultrasound detection of the back-projection of the high-velocity jet into the chamber. Myocardial wall abnormalities can be assessed using 2D ultrasound, M-mode or analysis from the radio-frequency-ultrasound signal. Doppler tissue imaging can be used to quantify intra-myocardial wall velocities, and 3D reconstruction of cardiac images can provide visualisation of the complete cardiac anatomy from any orientation. The development of myocardial contrast agents and associated imaging techniques to enhance visualisation of these agents within the myocardium has aided qualitative assessment of myocardial perfusion abnormalities. However, quantitative myocardial perfusion has still to be realised.

Cardiac Output↗

Development of an example flow test object and comparison of five of these test objects, constructed in various laboratories.

Doppler test objects are used to characterise Doppler systems, both stand-alone systems and the Doppler part of so-called duplex scanners. The aim of the project partially presented here is the development and validation of an example of a Doppler test object fulfilling the requirements of the IEC 1685. The project has been carried out by nine partners of five European countries and has been funded by the European Commission. The flow Doppler test object is composed of: tissue mimicking material (TMM), blood mimicking fluid (BMF), tube (embedded in the TMM and carrying the BMF), tank flow system, including a pump and a flow meter. In the normative part of the IEC 1685, requirements are given for the values of acoustical parameters of TMM and BMF such as sound velocity, attenuation and backscattering. For BMF, requirements are given also for values of density and viscosity. In an informative (but not compulsory) annex, a description is given of a flow test object meeting these requirements as an example. 'example test object' developed during the project is composed of TMM based on agar and including SiC- and Al2O3-powders, BMF based on nylon particles suspended in water and glycerine, and a tube of c-flex, a silicon copolymer. Two tube sizes are used: 4.0 mm ID and 8.0 mm ID. During the project, very precise recipes have been developed for the composition and preparation of both TMM and BMF. Based on these recipes and a description of the construction in a design five flow test objects have been constructed in the laboratories of five participants. The test objects have been compared by measurements of the physical parameters and by Doppler measurements of the five test objects with the Doppler system. The measurements have been carried out by five observers. Inter-test object and inter-observer variabilities are determined, yielding information about usefulness of the parameters.

Acoustics↗

An acoustic injection test object for colour flow imaging systems.

There are few test objects suitable for colour-flow ultrasound scanners. An acoustic injection device is described that enables the production of a 2-D region of colour on a colour-flow image. The device involves detection of the transmitted ultrasound pulse from the scanner, followed by the emission of a synthesized echo that consists of a radiofrequency burst modulated by an audiofrequency signal in such a way that, on reception by the ultrasound scanner, it is interpreted as a signal arising from a region of flow. The depth of the colour region may be controlled by adjustment of the length of the synthesised echo. The audiofrequency content may be altered as desired, enabling examination of the relationship between the displayed colour and the signal spectral content.

Acoustics↗