Comparison of B-mode, M-mode and echo-tracking methods for measurement of the arterial distension waveform

Measurements of arterial diameter throughout the cardiac cycle (i.e., the arterial distension waveform) are conducted increasingly to study mechanical properties of the arterial wall and changes associated with disease. The distension waveform of peripheral arteries can be measured noninvasively via ultrasonic echo tracking. M-mode imaging, and B-mode imaging. Of these, echo tracking is the most popular method because of its single micrometer resolution during continuous measurements under ideal conditions. However, high resolution within continuous measurements does not imply high reproducibility between measurements. Therefore, we compared repeated measurements of the amplitude of common carotid artery distension in 26 subjects, obtained sequentially in random order by: 1. Off-line echo tracking of digitized radiofrequency ultrasound; 2. M-mode imaging with automated edge detection; and 3. 30-Hz B-mode imaging with automated edge detection and model-based diameter estimation. In each case, the transducer was hand-held and was removed from the neck between repeated measurements. The amplitude of arterial distension was estimated from the serial diameter measurements by maximum likelihood (ML) estimation, by least-squares fit of a Fourier series model, and by application of a cubic smoothing spline. Within continuous measurements, the standard deviation of the ML distension amplitude for neighboring cardiac cycles was significantly smaller (p > 0.05) with echo-tracking (0.023 mm) than with the B-mode (0.036 mm) or M-mode (0.074 mm) methods. However, between discontinuous measurements on the same subject, the standard deviation of the ML distension amplitude was similar for the echo-tracking (0.076 mm) and B-mode (0.073 mm) methods. The Fourier series model and the cubic smoothing spline slightly reduced the standard deviation of the B-mode and M-mode distension amplitudes, but also reduced the mean amplitude estimate. On the basis of this relative comparison of methods, we conclude that, although echo tracking offers high resolution for continuous measurements, the reproducibility of discontinuous measurements of carotid artery distension is no better with echo tracking than can be obtained from 30-Hz B-mode images.