Cross-correlation analysis of pulse wave propagation in arteries: in vitro validation and in vivo feasibility.

The stiffness of the arteries is known to be an indicator of the progression of various cardiovascular diseases. Clinically, the pulse wave velocity (PWV) is used as a surrogate for arterial stiffness. Pulse wave imaging (PWI) is a non-invasive, ultrasound-based imaging technique capable of mapping the motion of the vessel walls, allowing the local assessment of arterial properties. Conventionally, a distinctive feature of the displacement wave (e.g. the 50% upstroke) is tracked across the map to estimate the PWV. However, the presence of reflections, such as those generated at the carotid bifurcation, can bias the PWV estimation. In this paper, we propose a two-step cross-correlation based method to characterize arteries using the information available in the PWI spatio-temporal map. First, the area under the cross-correlation curve is proposed as an index for locating the regions of different properties. Second, a local peak of the cross-correlation function is tracked to obtain a less biased estimate of the PWV. Three series of experiments were conducted in phantoms to evaluate the capabilities of the proposed method compared with the conventional method. In the ideal case of a homogeneous phantom, the two methods performed similarly and correctly estimated the PWV. In the presence of reflections, the proposed method provided a more accurate estimate than conventional processing: e.g. for the soft phantom, biases of  -0.27 and -0.71 m · s were observed. In a third series of experiments, the correlation-based method was able to locate two regions of different properties with an error smaller than 1 mm. It also provided more accurate PWV estimates than conventional processing (biases:  -0.12 versus -0.26 m · s). Finally, the in vivo feasibility of the proposed method was demonstrated in eleven healthy subjects. The results indicate that the correlation-based method might be less precise in vivo but more accurate than the conventional method.