Characterization of blood flow turbulence with pulsed-wave and power Doppler ultrasound imaging

Blood turbulence downstream of a concentric 86 percent area reduction stenosis was characterized using absolute and relative Doppler spectral broadening measurements, relative Doppler velocity fluctuation, and Doppler backscattered power. Bidimensional mappings of each Doppler index were obtained using a 10 MHz pulsed-wave Doppler system. Calf red cells suspended in a saline solution were used to scatter ultrasound and were circulated in an in vitro steady flow loop model. Results showed that the absolute spectral broadening was not a good index of turbulence because it was strongly affected by the deceleration of the jet and by the shear layer between the jet and the recirculation zones. Relative Doppler spectral broadening (absolute broadening divided by the frequency shift), velocity fluctuation, and Doppler power indices provided consistent mapping of the centerline axial variation of turbulence evaluated by hot-film anemometry. The best agreement between the hot-film and Doppler ultrasound methods was however obtained with the Doppler back-scattered power. The most consistent bidimensional mapping of the flow characteristics downstream of the stenosis was also observed with the Doppler power index. The relative broadening and the velocity fluctuation produced artifacts in the shear layer and in the recirculation zones. Power Doppler imaging is a new emerging technique that may provide reliable in vivo characterization of blood flow turbulence.