An investigation of simulated umbilical artery Doppler waveforms. I. The effect of three physical parameters on the maximum frequency envelope and on pulsatility index

The effect of three physical parameters on the accuracy of estimation of the maximum frequency envelope and pulsatility index (PI) of simulated umbilical artery Doppler waveforms was investigated. The physical parameters were beam-vessel angle, the offset between the beam axis and vessel axis, and the thickness of overlying attenuating material. Waveforms were acquired using a physiological flow phantom. The maximum frequency envelope was calculated using a threshold maximum frequency follower which was adaptive to the level of background noise. A gold standard maximum frequency envelope was obtained from the ensemble averaged waveform when there was alignment of beam and vessel axis, a 50 degrees beam-vessel angle and 2 cm of attenuating material. Indices of bias, variability and accuracy of estimation of the maximum frequency envelope and PI were calculated by comparing subsequent maximum frequency envelopes with the gold standard maximum frequency envelope. Both the maximum frequency envelope and PI were estimated to a similar degree of accuracy over a wide range of physical conditions. In this study, the error in PI was less than 0.15 for beam-vessel angles less than 80 degrees, for beam-vessel axis offset distances less than 7.5 mm, at a transducer-vessel distance of 5 cm, and for attenuator thicknesses less than 4.5 cm. The percentage root-mean square error for estimation of the maximum frequency envelope was approximately 10% or less for beam-vessel angles less than 75 degrees, for beam-vessel axis offset distances less than 7.5 mm, and for attenuator thicknesses less than 4 cm.