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The accuracy of ultrasound volume flow measurements in the complex flow setting of a forearm vascular access

(2013) JOURNAL OF VASCULAR ACCESS. 14(3). p.281-290
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Abstract
Purpose: Maturation of an arterio-venous fistula (AVF) frequently fails, with low post-operative fistula flow as a prognostic marker for this event. As pulsed wave Doppler (PWD) is commonly used to assess volume flow, we studied the accuracy of this measurement in the setting of a radio-cephalic AVF. Methods: As in-vivo validation of fistula flow measurements is cumbersome, we performed simulations, integrating computational fluid dynamics with an ultrasound (US) simulator. Flow in the arm was calculated, based on a patient-specific model of the arm vasculature pre and post AVF creation. Raw ultrasound signals were subsequently simulated, from which Doppler spectra were calculated in both a proximal and a distal location. Results: The velocity component in the direction of the PWD-US beam (V-PWD), in a centered, small, sample volume, can be captured accurately using PWD spectrum mean-tracking (maximum bias [mB] 8.1%). However, when deriving flow rate from these measurements, a high degree of inaccuracy occurs. First, the angle-correction of vim, towards the velocity along the axis of the vessel is largely influenced by the radial velocity components in the complex flow field (mB=16.3%). Second, the largest error is introduced when transferring the centerline velocity to the cross-sectional mean velocity without any knowledge of the flow profile (mB=97.7%). Conclusions: In the setting of a forearm AVF, flow estimates based on PWD are hampered by the complex flow patterns. Overall, flow estimation based on centerline measurement, analyzed by mean-tracking of the RF-spectral estimates, under the assumption of a parabolic flow profile, appeared to provide the most reasonable values.
Keywords
SIMULATION, Arterio-venous fistula, FAILURE, SIGNALS, FIELDS, HEMODIALYSIS-PATIENTS, BLOOD-FLOW, Pulsed wave Doppler, Ultrasound, ARTERIOVENOUS-FISTULAS, Blood flow determination, Computational study

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Citation

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Chicago
Van Canneyt, Koen, Abigaïl Swillens, Lasse Lovstakken, Luca Antiga, Pascal Verdonck, and Patrick Segers. 2013. “The Accuracy of Ultrasound Volume Flow Measurements in the Complex Flow Setting of a Forearm Vascular Access.” Journal of Vascular Access 14 (3): 281–290.
APA
Van Canneyt, K., Swillens, A., Lovstakken, L., Antiga, L., Verdonck, P., & Segers, P. (2013). The accuracy of ultrasound volume flow measurements in the complex flow setting of a forearm vascular access. JOURNAL OF VASCULAR ACCESS, 14(3), 281–290.
Vancouver
1.
Van Canneyt K, Swillens A, Lovstakken L, Antiga L, Verdonck P, Segers P. The accuracy of ultrasound volume flow measurements in the complex flow setting of a forearm vascular access. JOURNAL OF VASCULAR ACCESS. 2013;14(3):281–90.
MLA
Van Canneyt, Koen, Abigaïl Swillens, Lasse Lovstakken, et al. “The Accuracy of Ultrasound Volume Flow Measurements in the Complex Flow Setting of a Forearm Vascular Access.” JOURNAL OF VASCULAR ACCESS 14.3 (2013): 281–290. Print.
@article{4331617,
  abstract     = {Purpose: Maturation of an arterio-venous fistula (AVF) frequently fails, with low post-operative fistula flow as a prognostic marker for this event. As pulsed wave Doppler (PWD) is commonly used to assess volume flow, we studied the accuracy of this measurement in the setting of a radio-cephalic AVF.
Methods: As in-vivo validation of fistula flow measurements is cumbersome, we performed simulations, integrating computational fluid dynamics with an ultrasound (US) simulator. Flow in the arm was calculated, based on a patient-specific model of the arm vasculature pre and post AVF creation. Raw ultrasound signals were subsequently simulated, from which Doppler spectra were calculated in both a proximal and a distal location.
Results: The velocity component in the direction of the PWD-US beam (V-PWD), in a centered, small, sample volume, can be captured accurately using PWD spectrum mean-tracking (maximum bias [mB] 8.1\%). However, when deriving flow rate from these measurements, a high degree of inaccuracy occurs. First, the angle-correction of vim, towards the velocity along the axis of the vessel is largely influenced by the radial velocity components in the complex flow field (mB=16.3\%). Second, the largest error is introduced when transferring the centerline velocity to the cross-sectional mean velocity without any knowledge of the flow profile (mB=97.7\%).
Conclusions: In the setting of a forearm AVF, flow estimates based on PWD are hampered by the complex flow patterns. Overall, flow estimation based on centerline measurement, analyzed by mean-tracking of the RF-spectral estimates, under the assumption of a parabolic flow profile, appeared to provide the most reasonable values.},
  author       = {Van Canneyt, Koen and Swillens, Abiga{\"i}l and Lovstakken, Lasse and Antiga, Luca and Verdonck, Pascal and Segers, Patrick},
  issn         = {1129-7298},
  journal      = {JOURNAL OF VASCULAR ACCESS},
  keyword      = {SIMULATION,Arterio-venous fistula,FAILURE,SIGNALS,FIELDS,HEMODIALYSIS-PATIENTS,BLOOD-FLOW,Pulsed wave Doppler,Ultrasound,ARTERIOVENOUS-FISTULAS,Blood flow determination,Computational study},
  language     = {eng},
  number       = {3},
  pages        = {281--290},
  title        = {The accuracy of ultrasound volume flow measurements in the complex flow setting of a forearm vascular access},
  url          = {http://dx.doi.org/10.5301/jva.5000118},
  volume       = {14},
  year         = {2013},
}

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