ABSTRACT

Accurate characterization of tissue pathologies using ultrasonic attenuation is strongly dependent on the accuracy of the algorithm that is used to obtain the attenuation coefficient estimates. In this paper, computer simulations were used to compare the accuracy and the precision of the three methods that are commonly used to estimate the local ultrasonic attenuation within a region of interest (ROI) in tissue; namely, the spectral log difference method, the spectral difference method, and the hybrid method. The effects of the inhomgeneities within the ROI on the accuracy of the three algorithms were studied, and the optimal ROI size (the number of independent echoes laterally and the number of pulse lengths axially) was quantified for each method. The three algorithms were tested for when the ROI was homogeneous, the ROI had variations in scatterer number density, and the ROI had variations in effective scatterer size. The results showed that when the ROI was homogeneous, the spectral difference method had the highest accuracy and precision followed by the spectral log difference method and the hybrid method, respectively. Also, when the scatterer number density varied, the spectral difference method completely failed, while the log difference method and hybrid method still gave good results. Lastly, when the scatterer size varied, all of the methods failed.

Premature delivery is the leading cause of infant mortality in the United States. Currently, premature delivery cannot be prevented and new treatments are difficult to develop due to the inability to diagnose symptoms prior to uterine contractions. Cervical ripening is a long period that precedes the active phase of uterine contractions and cervical dilation. The changes in the microstructure of the cervix during cervical ripening suggest that the ultrasonic attenuation should decrease. The objective of this study is to use the reference phantom algorithm to estimate the ultrasonic attenuation in the cervix of pregnant human patients. Prior to applying the algorithm to in vivo human data, two homogeneous phantoms with known attenuation coefficients were used to validate the algorithm and to find the length and the width of the region of interest (ROI) that achieves the smallest error in the attenuation coefficient estimates. In the phantom data, we found that the errors in the attenuation coefficients estimates are less than 12% for ROIs that contain 40 wavelengths or more axially and 30 echo lines or more laterally. The reference phantom algorithm was then used to obtain attenuation maps of the echoes from two human pregnant cervices at different gestational ages. It was observed that the mean of the attenuation coefficient estimates in the cervix of the patient at a more advanced gestational age is smaller than the mean of the attenuation coefficient estimates in the cervix of the patient at an earlier gestational age which suggests that ultrasonic attenuation decreases with increasing gestational age. We also observed a large variance between the attenuation coefficient estimates in the different regions of the cervix due to the natural variation in tissue microstructures across the cervix. The preliminary results indicate that the algorithm could potentially provide an important diagnostic tool for diagnosing the risk of premature delivery.

To effectively postpone preterm birth, cervical ripening needs to be detected and delayed. As the cervix ripens, the spacing between the collagen fibers increases and fills with water, hyaluronan, decorin, and enzymes suggesting that the ultrasonic attenuation of the cervix should decrease. The decrease in ultrasonic attenuation may be detectable, leading to an effective means of detecting cervical ripening. Herein, the traditional attenuation slope-estimation algorithm based on measuring the downshift in center frequency of the ultrasonic backscattered signal with propagation depth was modified and applied to the cervix of rats. The modified algorithm was verified using computer simulations and an ex vivo tissue sample before being evaluated in in vivo animal studies. Sphericallyfocused f/3 transducers with 33-MHz center frequencies and with 9-mm focal lengths were used in both the simulations and experiments. The accuracy was better than 15% in the simulations, and the attenuation slope of the cervix in the ex vivo experiment was 2.6±0.6 dB/cm-MHz, which is comparable to 2.5±0.4 dB/cm-MHz measured using a through-transmission insertion loss technique. For the in vivo experiments, a statistically significant effect of ultrasonic attenuation with gestational age was not observed. The large variances in the in vivo results were most likely due to the natural variation in attenuation for biological tissue between animals.

No abstract