Performance assessment of pulse wave imaging using conventional ultrasound in canine aortas ex vivo and normal human arteries in vivo

• Performed ex vivo and in vivo parametric assessment of pulse wave imaging (PWI).
• Optimal scan line density for PWVs ∼2.5–3.5 m/s was 0.63–1.26 lines/mm.
• 50% upstroke of in vivo pulse waveforms yielded the most reliable measurements.

The propagation behavior of the arterial pulse wave may provide valuable diagnostic information for cardiovascular pathology. pulse wave imaging (PWI) is a noninvasive, ultrasound imaging-based technique capable of mapping multiple wall motion waveforms along a short arterial segment over a single cardiac cycle, allowing for the regional pulse wave velocity (PWV) and propagation uniformity to be evaluated. The purpose of this study was to improve the clinical utility of PWI using a conventional ultrasound system. The tradeoff between PWI spatial and temporal resolution was evaluated using an ex vivo canine aorta (n = 2) setup to assess the effects of varying image acquisition and signal processing parameters on the measurement of the PWV and the pulse wave propagation uniformity r2. PWI was also performed on the carotid arteries and abdominal aortas of 10 healthy volunteers (24.8 ± 3.3 y.o.) to determine the waveform tracking feature that would yield the most precise PWV measurements and highest r2 values in vivo. The ex vivo results indicated that the highest precision for measuring PWVs ∼2.5–3.5 m/s was achieved using 24–48 scan lines within a 38 mm image plane width (i.e. 0.63–1.26 lines/mm). The in vivo results indicated that tracking the 50% upstroke of the waveform would consistently yield the most precise PWV measurements and minimize the error in the propagation uniformity measurement. Such findings may help establish the optimal image acquisition and signal processing parameters that may improve the reliability of PWI as a clinical measurement tool.