An ultrasonic system for diameter pulse tracking in arteries: problems and pitfalls

Non-invasive ultrasonic techniques for measuring the mechanical behaviour of large arteries have a potential clinical application for physiological studies of the circulation and early detection of degenerative arterial disorders. A newly developed system for such purposes, comprising two double-echo trackers with zero-crossing phase-locked circuits and interfacing a B-mode real-time scanner, has been introduced for on-line recording of the diameter in a selected aortic segment. The aim of this report is to draw attention to the limitations of the technique in order to avoid misinterpretation of results. The various problems associated with the use of phase-locked echo followers for tracking sonic echoes of vessel pulse waves are summarized. The high spatial resolution of the measuring system is essential for estimating the elastic properties of the vessel, because the fractional changes of the diameter waveform during a heart cycle are small compared with the swings of intravascular pressure. Measuring errors may originate from either human or technical sources. From several viewpoints correct alignment of the ultrasonic beam vis-à-vis the vessel segment under consideration is crucial for obtaining valid measures. A thorough knowledge of the physics involved is essential for an adequate use of the instrument. With correct use, easily reproducible and reliable estimations are obtained of the mechanical properties of large vessel walls.