An ultrasonic system for measurement of absolute myocardial thickness using a single transducer

Abstract

We have developed an ultrasonic instrument that can measure absolute regional myocardial wall motion throughout the cardiac cycle using a single epicardial piezoelectric transducer. The methods in place currently that utilize ultrasound to measure myocardial wall thickness are the transit-time sonomicrometer (TTS) and, more recently, the Doppler echo displacement method. Both methods have inherent disadvantages. To address the need for an instrument that can measure absolute dimensions of myocardial wall at any depth, an ultrasonic single-crystal sonomicrometer (SCS) system was developed. This system can identify and track the boundary of the endocardial muscle-blood interface. With this instrument, it is possible to obtain, from a single epicardial transducer, measurement of myocardial wall motion that is calibrated in absolute dimensional units. The operating principles of the proposed myocardial dimension measurement system are as follows. A short duration ultrasonic burst having a frequency of 10 MHz is transmitted from the piezoelectric transducer. Reflected echoes are sampled at two distinct time intervals to generate reference and interface sample volumes. During steady state, the two sample volumes are adjusted so that the reference volume remains entirely within the myocardium, whereas half of the interface sampled volume is located within the myocardium. After amplification and filtering, the true root mean square values of both signals are compared and an error signal is generated. A closed-loop circuit uses the integrated error signal to continuously adjust the position of the two sample volumes. We have compared our system in vitro against a known signal and in vivo against the two-crystal TTS system during control, suppression (ischemia), and enhancement (isoproterenol) of myocardial function. Results were obtained in vitro for accuracy (> 99%), signal linearity (r = 0.99), and frequency response to heart rates > 450 beats/min, and in vivo data were acquired for end-systolic dimension (r = 0.99), end-diastolic dimension (r = 0.99), and percent wall thickness (r = 0.99). Both in vitro and in vivo tests indicate that the SCS functions identically to the two-crystal TTS. Use of the SCS allows measurement of absolute wall thickness and hence myocardial function, for both acute and chronically instrumented animal studies, with minimal or no trauma to myocardium.