Prevention and early detection of atherosclerosis are critical for protection against subsequent circulatory disease. In this study, an automated two-dimensional ultrasonic-measurement-integrated (2D-UMI) blood flow analysis system for clinical diagnosis was developed, and the feasibility of the system for hemodynamic analysis in a carotid artery was revealed. The system automatically generated a 2D computational domain based on ultrasound color Doppler imaging and performed a UMI simulation of blood flow field to visualize hemodynamics in the domain. In the UMI simulation, compensation of errors was applied by adding feedback signals proportional to the differences between Doppler velocities by measurement and computation while automatically estimating the cross-sectional average inflow velocity. The necessity of adjustment of the feedback gain was examined by analyzing blood flow in five carotid arteries: three healthy, one sclerosed, and one stenosed. The same feedback gain was generally applicable for the 2D-UMI simulation in all carotid arteries, depending on target variables. Thus, the present system was shown to be versatile in the sense that the parameter is patient independent. Moreover, the possibility of a new diagnostic method based on the hemodynamic information obtained by the 2D-UMI simulation, such as a waveform of the cross-sectional average inflow velocity and wall shear stress distributions, was suggested.

If highly precise elucidation of the blood flow characteristics in a carotid bifurcation was possible, it would be widely applicable to diagnosis of circulatory diseases such as arteriosclerosis and cerebrovascular disease. This study was conducted to establish a new flow-dividing ratio estimation method applicable to an unsteady flow on a two-dimensional ultrasonic-measurement-integrated simulation of a carotid artery bifurcation for which it has been previously difficult to obtain a stable solution. In this new method, the flow-dividing ratio was directly adjusted by specifying the flow rate in a branch so that the difference of the Doppler velocities in the external carotid artery was decreased. The effectiveness of the proposed method was confirmed by a numerical experiment using the actual shape of a carotid artery bifurcation, and the superiority of the two-dimensional ultrasonic-measurement-integrated simulation over the ordinary simulation in terms of the reproducibility of the blood flow structure was clarified by analysis using clinical ultrasound data.

We developed a simultaneous analysis system for blood pressure and flow using photoplethysmography and ultrasonic-measurement-integrated simulation. The validity of the system was confirmed by analysis of blood flow field in a carotid artery and corresponding wave intensity (WI) values.

Understanding the spatiotemporal change in hemodynamics is essential for the basic research of atherosclerosis. The objective of this study was to establish a methodology to clarify the relation between a two-dimensional (2D) unsteady blood flow field and forward and backward propagating waves in a carotid artery. This study utilized photoplethysmography (PPG) for blood pressure measurement and two-dimensional ultrasonic-measurement-integrated (2D-UMI) simulation for flow field analysis. The validity of the methodology was confirmed in an experiment for a carotid artery of a healthy volunteer. Synchronization between the pressure measurement and flow field analysis was achieved with an error of <10 ms. A 2D unsteady blood flow field in the carotid artery was characterized in relation to forward and backward waves. 2D-UMI simulation reproduced the flow field in which the wall shear stress takes a maximum at the time of the backward wave superiority in the systolic phase, whereas 2D ordinary simulation failed to reproduce this feature because of poor reproducibility of velocity distribution. In conclusion, the proposed methodology using PPG and 2D-UMI simulation was shown to be a potential tool to clarify the relation between 2D unsteady blood flow field and the forward and backward waves in a carotid artery.

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