Flow Imaging Cardiac

Ultrasound system
by Larry Miller PhD
www.linkedin.com/in/lrmiller
miller@elect-design.com
US Patent 4,612,937
Ultrasound Diagnostic Apparatus,
Inventor: Lawrence (Larry) R Miller

1/21/2014

Cardiac ultrasound technology existing

at start of project
Anatomical imaging ultrasound
Manually aimed and rotated for desired fan
placement. Produces 2D fan image
Observe heart wall motion, valve leaflet motion, etc.
Display: 2D fan-shaped grayscale reflectivity image: Heart
structures are reflective, blood shows minimally visible
reflectivity.

Doppler probe
Manually aimed in desired direction
Shows blood velocity as a function of depth (distance
from probe along the 1-dimensional beam)
Display: strip chart similar to a sonogram V=depth, H=time
1/21/2014

Project goal:
Flow-imaging cardiac ultrasound
Requirements
Display real-time anatomical image of heart and
related structures as grayscale
Superimpose image of blood flowing towards the
probe in red and away from the probe in blue

1/21/2014

Example of Flow imaging ultrasound

Mitral insufficiency

1/21/2014

From http://www.ntnu.edu/isb/ultrasound/bloodflow
Norwegian University of Science and Technology

Flow imager pulse sequence

Ultrasound frequency f0

3.5 MHz. This is typical for cardiac ultrasound as it

provides adequate penetration depth. = 0.43 mm.

Pulse sequence
N pulses in a given direction them move to the next
direction
Frequency resolution increases with increasing N. N=5
chosen for first prototype

Pulse repetition rate

A typical cardiac image will be 10 cm deep
Speed of sound in tissue and water c = 150,000 cm./sec.
Pulse rate thus Fpulse = 7500 pulses per second.
1/21/2014

Flow imager architecture

Single element oscillating probe vs phased array
probe
Acquiring Doppler signal requires multiple pulses in
the same direction before moving to the next
direction
Oscillating probe cannot perform move and stop,
move and stop, thus phased array probe needed
Added advantage: phased array probe allows dynamic
receive focus, providing greater effective depth of focus

1/21/2014

Doppler velocity detection parameters

Max unambiguous blood velocity vmax
Nyquist: max unambiguous Fd is Fpulse / 2 which is 3750 Hz
Backscatter Doppler frequency Fd = 2 f0 v / c where v is
blood velocity. v = Fd c / (2 f0 )
Practical max. for 5 pulse sequence is 80% of Nyquist
vmax = 0.8 x 3750 x 150,000 / (2 x 3.5 x 106 ) = 64 cm. / sec.

Interleaving
An interleaved by m pulse sequence will have vmax = (64 /
m) cm./sec. This mode is used for observing flows with
lower peak velocities.
1/21/2014

Flow imager fan

Fan width: 90 degrees
Probe elements:

linear array of 32 elements

Lead zirconate titanate (PZT) (ATL Technologies)
dielectric constant 700
Longitudinal resonance thru thickness: 3.5 MHz
Backed by carbon loaded silicone:
reduces Q of longitudinal resonance to 3

Probe Dimensions
15 mm wide by 10 mm high
1/21/2014

Array patterns
Single element response

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Array patterns
Array response for four steering angles

1/21/2014

Infinite focus case

10

Blood velocity estimator

Requirements
Should not respond to low velocities.
Should use a minimal number of pulse samples in order to
achieve high frame rate

Vest(beam_direction,depth_bin) =
abs (

5
1 []

[])2 abs (

5
1 (

) [])2

c[i] are 5 fixed coefficients: 1-2i, -4+4i, 6, -4-4i, 1+2i

d[i] are 5 consecutive data points for 5 consecutive pulses along
the given beam direction in the given depth bin

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11

Blood velocity estimator

Doppler frequency estimator response function

Nyquist band

Relation between velocity and Doppler frequency: v = Fd c / (2 f0 )

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12

Electronic block diagram

Receive signal
combiner

cable

32 piezoelectric
element ultrasound
probe

32 element
driver/receiver
boards

Digital
controller

Log amplifier
& detector

Anatom.
image
Color
NTSC
formatter
Display
1/21/2014

2 x D to A
converter

Polar to
rectangular
scan
converter

Blood
veloc.

A to D
converter
Digital
Doppler
processor

13

Element Driver/Receive board

Pulse
generator

Probe
element

agc1

Matching
network &
Preamplifier

agc2

agc3

3 subsequent
gain-controlled
amplifier stages

Combined
analog receive
signal
(drive to
backplane analog
bus)

agc4

mux
Fine delay
line
0.05 s/tap

mux
Coarse
delay line
0.5 s/tap

Outputs change during

receive interval to
implement dynamic focus

Static
RAM
Memory download and control from
backplane

14
1/21/2014

Doppler processor electronics

Doppler processor detail
Combined
analog
receive signal

3 MHz
transmit
oscillator
output

Digital logic

I and Q
demodulator
and digitizer

From US Patent 4,612,937

Blood velocity signal

1/21/2014

15

Matching network and preamplifier

(simplified parasitic snubbing resistors omitted)
Probe
element
equivalent
circuit

Cascode
stage
Zload

+V
bias

V supply
Preamp
output to
next stage

Lt

Rp
Cp

+I bias

G
S

Cc

G
S

4x
2N4416
S JFET

Lp
Voltage source
proportional to
ultrasound signal

AGC in
-I bias
1/21/2014
Pulse

in

Cf (4 x parasitic cap. G to S) = 16 pF
Lt = 14.6 uH Cp = 10 pF Lp = 220 uH
Rp = 1.6 kOhm Cc = 134 pF

16

Preamplifier Noise Figure

Noise Figure at 3.5 MHz
NF = 20 log (Vt / Vs)
A measure of noise added by the preamplifier
Vt = total noise voltage per at preamp output
Vs = noise voltage contributed by source resistance Rp per at preamp output

Vs = G 4 kTRp per = 4.4 nV per

G = preamplifier gain E/e

Vt = 2 + 2
= 3 nanovolts per
Each JFET has 6 nV per noise, so 4 averaged provides 3 nV per

= 5.32 / 4.4 = 1.21

NF = 1.65 dB
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17

Probe and matching network

frequency response

Relative
response
amplitude

Frequency (MHz)

Half power band: 3.0 MHz to 3.9 MHz

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18

Probe and preamp input network

impulse response

Envelope full width half maximum = 0.88 microseconds

Corresponds to 0.66 mm depth range.
Thus depth resolution is 0.66 mm
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19

Automatic Gain Control (AGC)

Four successive AGC amplifier stages
starting with preamp
Chart shows control voltage applied to each of these 4
stages, and the total AGC achieved
AGC in voltage
is linearly related
to 10gain_in_dB/20
AGC in voltages ramps are
Generated from table
Driving DAC

1/21/2014

20

Log amplifier
simplified schematic
3 of 6 stages shown

Input

+supply

HF limiting
amplifier
stages
(Bandpass
filtering not
shown)

Output
-supply
Detector
zero
reference

Current
mirror

Detector
stages

R/6
-bias

-supply

-supply

1/21/2014

R
-supply

21

Log amplifier stage transfer functions

HF limiting amplifier stage
transfer function

(exp (Ein/2) - exp(-Ein/2))/(exp (Ein/2) +

exp(-Ein/2))
E0 = kT/q 27 mV.
Ein =
stage input voltage / E0
Stage output voltage =
Gain * Eout * E0
Gain = 10 dB

Detector stage transfer

function

1/21/2014

Detector: Eout = log(1 + exp (Ein))

Ein = detector input voltage / E0
Detector output voltage = Eout * E0

22

Log Amplifier transfer function

from model
Gain 20 dB per
differential
amplifier stage

Gain 10 dB per
differential
amplifier stage
This gain per stage
was used for
prototype
1/21/2014

Output signal
level
linear scale

Output signal
level
linear scale

Input signal level in dB

23

Dynamic apodization
Contributions from elements at each end
reduced for first 1 cm.
Reduces sensitivity to reflections from adjacent ribs
Method: agc for outer elements reduced over first 1 cm.

1/21/2014

24

Scan Converter
10 cm. depth mode: 0.39 mm. per raster line

Raster
lines

1
2

Raster lines 1
to 256
Scan convert
on write

Raster lines 17
to 256
Scan convert on
read
256

1/21/2014

128 beam directions

Raster scanout: 2048 pixels in 40 sec 50 MHz output pixel clock

25

Scan Converter
10 cm. depth mode: 0.39 mm. per raster line

Raster
lines

1
2

Raster lines 1
to 256
Scan convert
on write

Raster lines 17
to 256
Scan convert on
read
256

1/21/2014

128 beam directions

Raster scanout: 2048 pixels in 40 sec 50 MHz output pixel clock

26

Clinical tests of prototypes

Approvals and tests
Preapproved by review board at all medical facilities
where tested as investigational device exemption
Substantially equivalent to Toshiba diagnostic ultrasound
device. Same power levels, repetition rate, probe area,
and general function.
Tested by cardiologists at ten hospitals

Results
Image rated very good and flow imaging worked well on
most patients.
No interference artifact (because of good isolation of
sensitive electronics from digital electronics)
1/21/2014

27

Appendix
FDA output limits for diagnostic ultrasound
A spatial-peak temporal-average intensity (ISPTA) less than 720 mW/cm2.
The acoustic output depends on the output power, pulse repetition
frequency, and scanner operating mode (eg, B-mode, M-mode, pulsed, or
color or power Doppler imaging).4,9
J Ultrasound Med 2009; 28:139150 141

Power output of our prototype

Pulse width: 0.8 microseconds. Min rep period: 133 sec

Pulse voltage: 10 volts. Minimum probe impedance: 1600 ohms.
Max instantaneous power generated: 32 x 102/1600 = 2.0 watts
Max temporal average power (at spatial peak) 2.0 x 0.8/133 = 12 mW
Probe active area: 1.6 cm2
Max spatial peak temporal average power per cm < 7.6 mW
Probe carbon-loaded silicone backing absorbs some of the energy

1/21/2014

28