Ultrasound Mitral Valve Regurgitation Orifice Detection
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Solution Overview
Problem
Current diagnostic ultrasound systems face challenges in accurately quantifying mitral regurgitation flow due to difficulties in capturing the peak jet duration, defining the valve orifice location, and accounting for Doppler angle variations, leading to inaccurate flow rate calculations, especially when regurgitation occurs through a slit rather than a single pinhole.
Innovation Solution
An ultrasonic diagnostic imaging system and method that delineates an arcuate or hemispherical region proximal to the presumed mitral valve leak, computes a velocity field model, adjusts parameters based on ultrasound physics and system settings, and iteratively refines measurements to accurately quantify flow rate and orifice location, while accounting for Doppler angles and image clutter.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If the PISA technique is used to quantify regurgitant blood flow, then flow rate measurement is enabled, but measurement precision deteriorates due to difficulty in capturing the peak jet moment and defining the valve orifice location
Solution Approach 1:
The system performs preliminary actions by automatically detecting the valve orifice location and defining the flow convergence region boundaries before measuring flow rate. The orifice location is determined by analyzing the flow convergence region geometry and aliasing patterns in advance, establishing accurate reference points for subsequent measurements.
Solution Approach 2:
The system uses feedback by continuously comparing measured velocity profiles against the mathematical model predictions and iteratively adjusting the orifice location and flow convergence region boundaries. This feedback loop refines the measurement parameters until the modeled and measured velocities converge, improving measurement precision.
2Measurement precision
If multiple velocity measurements are made around the FCR arc to compensate for single measurement inaccuracies, then measurement precision improves, but device complexity increases due to multiple measurement points and Doppler angle corrections
Solution Approach 1:
The system segments the flow convergence region into multiple measurement points around the arc, with each point having its own velocity measurement. This segmentation allows the system to capture the velocity field distribution and use the geometric relationships between points to eliminate Doppler angle dependencies, improving precision without requiring complex manual corrections.
Solution Approach 2:
The system replaces manual Doppler angle correction calculations with an automated mathematical model that uses the geometric relationships between multiple measurement points. The model computationally eliminates the need for angle-by-angle corrections by using the velocity field distribution and flow convergence geometry to directly calculate flow rate.
3Measurement precision
If the ultrasound beam is aligned with the regurgitant flow vector to obtain accurate velocity measurement, then measurement precision improves, but adaptability deteriorates because the beam cannot simultaneously capture flow at multiple angles
Solution Approach 1:
The system achieves multi-functionality by using a single ultrasound beam to perform multiple measurements at different locations around the flow convergence region arc. Each measurement point provides velocity data that contributes to the overall velocity field characterization, allowing the system to adapt to different flow configurations without requiring multiple independently aligned beams.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach enables precise identification and quantification of mitral valve regurgitation, providing accurate flow rate measurements and orifice location, even in cases of slit-like leaks, by iteratively adjusting the model parameters to match measured velocities, thus overcoming the limitations of existing PISA techniques.
Implementation Method 1
the high speed and turbulence of the small jet of blood is detected by careful search for these abnormal local flow velocities near the leaking heart valve
Data Source
AI summary
An ultrasonic diagnostic imaging system is described which quantifies regurgitant flow through a mitral valve, including the automatic indication of the location of a regurgitant orifice in an ultrasound image. A clinician images the regurgitant valve and indicates in the image the presumed location of the regurgitant orifice (130). A flow quantification processor is responsive to this initial location estimate by the clinician to calculate a refined estimation of the orifice location. The refined location is indicated on the ultrasound image by the imaging system, either by relocating an icon placed by the clinician, or displaying a second icon (132) on the image at the refined location.