Ultrasound in Med. & Biol., Vol. 25, No. 8, pp.

1221–1227, 1999
Copyright © 1999 World Federation for Ultrasound in Medicine & Biology
Printed in the USA. All rights reserved
0301-5629/99/$–see front matter

PII S0301-5629(99)00083-6

● Original Contribution

IMPLEMENTATION OF SPECTRAL WIDTH DOPPLER IN PULSATILE

FLOW MEASUREMENTS

BOR-RAY LEE*, HUIHUA KENNY CHIANG*, YI-HONG CHOU†, CHENG-DENG KUO‡,

JIA-HORNG WANG‡ AND SAN-KAN LEE§
*Institute of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan; †Department of Radiology
General Veteran Hospital-Taipei/National Yang-Ming University, Taipei, Taiwan; ‡Department of Respiratory
Therapy, General Veteran Hospital-Taipei/National Yang-Ming University, Taipei, Taiwan; §Department of
Radiology, General Veteran Hospital-Taichung, Taichung, Taiwan

(Received 4 January 1999; in final form 7 June 1999)

Abstract—In this paper, we present an automatic beam-vector (Doppler) angle and flow velocity measurement
method and implement it in pulsatile flow measurements using a clinical Doppler ultrasound system. In current
clinical Doppler ultrasound flow velocity measurements, the axis of the blood vessel needs to be set manually on
the B-scan image to enable the estimation of the beam-vector angle and the beam-vector angle corrected flow
velocity (the actual flow velocity). In this study, an annular array transducer was used to generate a conical-
shaped and symmetrically focused ultrasound beam to measure the flow velocity vectors parallel and perpen-
dicular to the ultrasound beam axis. The beam-vector angle and flow velocity is calculated from the mode
frequency (fd) and the maximum Doppler frequency (fmax) of the Doppler spectrum. We develop a spectrum
normalization algorithm to enable the Doppler spectrum averaging using the spectra obtained within a single
cardiac cycle. The Doppler spectrum averaging process reduces the noise level in the Doppler spectrum and also
enables the calculation of the beam-vector angle and flow velocity for pulsatile flows to be measured. We have
verified the measurement method in vivo over a wide range of angles, from 52° to 80°, and the standard deviations
of the measured beam-vector angles and flow velocities in the carotid artery are lower than 2.2° and 12 cm/s
(about 13.3%), respectively. © 1999 World Federation for Ultrasound in Medicine & Biology.

Key Words: Flow velocity measurement, Doppler spectrum, Beam-vector angle, Spectrum averaging,
Annular array

INTRODUCTION axis. Hein (1997) used a three-transducer probe to mea-

Medical Doppler ultrasound is a powerful tool for de-
tecting blood vessel disease in patients, and has been
widely used to measure the flow velocity in blood ves-
sels. In spectral Doppler ultrasound, knowledge of the
beam-vector angle between the nominal beam direction
and the direction of blood motion is required. The oper-
ator manually set the angle cursor along the blood vessel
on the B-scan image (Fish 1990). This process is incon-
venient, operator-dependent, and is inaccurate for mea-
suring the beam-vector angle. Recently, many research-
ers have developed several flow velocity measurement
methods to solve this problem. Bohs et al. (1993, 1995)
used a two-dimensional speckle tracking technique to
measure the flow velocity perpendicular to the beam
Address correspondence to: Dr. Huihua Kenny Chiang, National
Yang-Ming University, Institute of Biomedical Engineering, 155, Section
2, Li-Numg Street, Taipei 112, Taiwan. E-mail: chiang@bme.ym.edu.tw
sure the flow vectors in three-dimensional space. New-
house et al. (1987) used lateral transit time broadening
(Andrew and Junru 1995; Censor et al. 1988; Chabria
and Newhouse 1997; Tortoli et al. 1995) to measure the
flow velocity perpendicular to the beam axis, and they
also used two transducers (Newhouse et al. 1994) to
measure flow vectors in three-dimensional space. One
promising technique, an automatic Doppler angle and
flow velocity estimation method (Lee and Chiang 1999)
that utilizes the combination of classic and transverse
Doppler effects, has been validated for constant flow
measurements. This technique uses only one annular
array transducer to generate a symmetrically focused
ultrasound beam to measure the Doppler spectrum,
which inherently contains the information of the trans-
verse and longitudinal components of the flow vectors
(as seen in Fig. 1). Therefore, the beam-vector angle and
flow velocity could be measured. However, due to pres-

1221
1222 Ultrasound in Medicine and Biology
Fig. 1. The schematic diagram of the beam-vector angle and
flow velocity measurement using an annular array transducer.
The transverse, longitudinal components of the flow velocity,
and the beam-vector angle can be measured. VA and VB are two
arbitrary flow vectors with the same beam-vector angle.
ence of noise and signal variations in the Doppler spec-
trum, the Doppler spectrum needs to be averaged many
times to reduce the spectral noise. Figure 2 shows the
variation in the calculated beam-vector angle vs. the
number of spectral lines in the averaging. The standard
deviations of the calculated angles are less than 2°, when
more than 15 spectra are used in the averaging. Because
the flow velocity of a constant flow is time-invariant, the
Doppler spectra can be directly averaged, whereas in
pulsatile flow conditions, the flow velocities are time-
Fig. 2. The calculated beam-vector angle vs. the number of
spectrum averaging times for a constant flow measured at 70°,
33 cm/s.
Volume 25, Number 8, 1999
variant, so the Doppler spectra cannot be averaged di-
rectly, as in constant flow measurements.
Although many blood flow velocity measurement
techniques have been developed, a spectral Doppler-
based ultrasound flow velocity measurement method that
utilizes only one transducer and is capable of measuring
pulsatile flows has not yet been presented. In this paper,
we theoretically developed a Doppler spectrum normal-
ization algorithm, an effective and fast Doppler spectra
data-averaging process to be finished in a single cardiac
cycle, for pulsatile flow measurements, and experimen-
tally implemented this measurement method to in vivo
pulsatile flow measurements.
PRINCIPLE
In classic Doppler, the relationship between the
flow velocity v and the mode frequency fd of the Doppler
spectrum is:
2䡠v
fd ⫽ 䡠 cos␪ (1)
␭
where ␭ is the wavelength of acoustic wave, and ␪ is the
measured beam-vector angle. Sometimes, fd is also re-
ferred to as the mean frequency of the Doppler spectrum
(Tortoli et al. 1995), rather than the mode frequency used
in this article. Theoretically, when the center of the
sample volume is much smaller than the diameter of a
conduit and is positioned at the center of the conduit, the
mean frequency equals to the mode frequency (Law et al.
1991).
For a converging ultrasound beam crossed by a flow
line, a multiplicity of ray-to-flow line angles can be said
to exist. Instead of a single frequency shift, a broad-range
frequency shift around fd would be observed in a mea-
sured Doppler spectrum. This broadening effect has been
described as transverse Doppler theory by Newhouse et
al. (1987) and is described by the following equation:
2␯ W
Bd ⫽ 䡠 䡠 sin␪ (2)
␭ F
where Bd is the spectrum bandwidth, W is the aperture of
transducer and F is the focal length.
Tortoli et al. (1995) have shown that the maximum
frequency (fmax) of the Doppler spectrum could be rep-
resented as fd plus one-half of the Doppler spectrum
bandwidth. The Doppler spectrum bandwidth represents
the transverse component of the flow velocity measured
by the transducer. The maximum frequency fmax of the
Doppler spectrum is:
 Spectral width Doppler in pulsatile flow ● B.-R. LEE et al.
␯W
f max ⫽ f d ⫹ 䡠 sin␪
␭ F
The longitudinal and transverse components of the flow
velocity vectors could be represented by the functions of
fd and (fmax ⫺ fd). Therefore, the flow velocity and the
beam-vector angle could be represented as (derived in
Appendix A):
冑冋 册 冋
册
␭ 2
␭䡠F
␯⫽ 䡠f ⫹ 䡠 共 f max ⫺ f d兲
2 d W
␪ ⫽ tan⫺1 冋 f max ⫺ f d 2 䡠 F
fd
䡠
W 册
Equations (4) and (5) have been theoretically derived and
experimentally verified in constant flow measurements
(Lee and Chiang 1999).
The main problem associated with using eqns (4)
and (5) is that the Doppler spectrum needs averaging to
reduce the noise level, and then to determine the stable
values of fd and fmax. Averaging a consecutive set of
Doppler spectra is straightforward in constant flow mea-
surements, but requires ECG gating or some other means
for pulsatile flow measurements. Figure 2 shows the
variation of the calculated beam-vector angle vs. the
number of lines of spectral data averaged. The beam
vessel angle was set at 70° and the standard deviation
was less than 2° after 15 spectra lines were averaged. The
Doppler spectrum-averaging process reduces the noise
level and fluctuations in the spectrum, and improves the
accuracy of the measurement. However, in pulsatile flow
measurements, the flow velocities vary with time; thus,
the spectrum cannot be averaged directly as in constant
flow measurements.
To reduce the noise level and fluctuations in the
Doppler spectrum obtained from a pulsatile flow mea-
surements, a Doppler spectrum normalization and aver-
aging algorithm is developed. The normalization of the
Doppler spectrum is based on the assumption that the
beam-vector angle is unchanged during the fast systolic
region of the cardiac cycle (about 0.12 s). Therefore, for
pulsatile flows measured at a fixed beam-vector angle,
the maximum Doppler shift frequency fmax can be sim-
plified from eqn (3):
f max ⫽ ␯ 䡠 ⌬
where the constant
⌬⫽
2
␭冉cos␪ ⫹
W
2䡠F
䡠 sin␪ 冊 curve. In this experiment, the threshold was determined
1223
Therefore, fmax only depends on the flow velocity v,
(3) and the parameters, ␭, W, ␪, and F, are fixed constants.
For two spectra with different flow velocities measured
at the same beam-vector angle (denoted spectrum⫺1 and
spectrum⫺2), the scaling factor between spectrum⫺1
(flow velocity v1) and spectrum⫺2 (flow velocity v2) can
be determined as:
f max⫺1 ␯ 1
R⫽ ⫽
(7)
2 f max⫺2 ␯ 2
(4)
The scaling factor R can be also determined from the
ratio of the energy peak Doppler frequency fd⫺1 兾fd⫺2.
(5) Because the maximum Doppler shift frequency fmax
would be less noisy, the ratio of fmax⫺1兾fmax⫺2 is used to
determine the scaling factor R. Thus, a set of Doppler
spectra can be normalized to a specific Doppler spectrum
by a scaling factor R before the spectrum-averaging
process.
METHODS
Flow phantom measurement
Doppler systems. A color Doppler ultrasound sys-
tem, GE-Vingmed CFM-750 (GE-VingMed Sound,
Horten, Norway), with a four-element annular array
transducer, operating at 2.5 MHz in Doppler mode and
3.25 MHz in B-scan, 1.47 cm in diameter and 7.8 cm in
focal length, was used in the flow phantom experiments.
The length of sample volume was kept at 1.5 mm long
and was set at the focus. The pulsed repetition frequency
was 10 kHz. Each Doppler spectrum calculation time
(including sampling and computation time) in the CFM-
750 is less than 8 ms.
Flow phantom. We used a UHDC (Shelley Medical
Imaging Technologies, London, Ontario, Canada) flow
phantom to generate pulsatile flows. The flow velocity at
the systolic peak of pulsatile flow was set at 33 cm/s in
a latex conduit with a 9.5-mm internal diameter. The
conduit was 1 m long and was immersed horizontally in
a water tank. The UHDC blood mimic fluid was used as
the scattering source in the flow. The density of the fluid
was 1.01 g/mL, and the dynamic viscosity was 1.34 cp (1
cp ⫽ 10⫺2 g/s 䡠 cm ).
Signal processing. The maximum Doppler fre-
quency fmax is defined as the intersection of the Doppler
(6) spectrum, and an empirically determined threshold is set
at ⫺6 dB. The setting of the threshold for fmax should be
empirically determined for each Doppler ultrasound sys-
tem, because each system has its own Doppler gain
by calibrating a set of estimated beam-vector angles to a
1224 Ultrasound in Medicine and Biology
set of known angles (e.g., 50°, 60°, 70°) set in UHDC
flow phantom. Different thresholds (including ⫺6 dB,
⫺8 dB, ⫺10 dB, ⫺15 dB and ⫺20 dB) have been
empirically tested by a controlled flow phantom system.
In measuring the flow velocity of the pulsatile flow,
a consecutive set of the Doppler spectra was obtained in
the systolic cycle (as shown in the white dotted rectan-
gular window in Fig. 3A). These measured spectra were
normalized to the Doppler spectrum at the systolic peak
and were averaged to obtained a less noisy Doppler
spectrum. The reasons why we chose the Doppler spectra
in the systolic cycle were that (1) the spectra of fast flows
would be less affected by the wall filter of the Doppler
system, and (2) to insure the measured spectra to be in
the laminar flow.
Figure 3A shows the Doppler spectrum of a pulsa-
tile flow generated by a UHDC flow phantom. The
systolic peak flow velocity was set at 33 cm/s. The
beam-vector angle was set at 50°. A consecutive set of
Doppler spectra obtained during the systolic cycle was
normalized and averaged to estimate the beam-vector
angle and the flow velocity at the systolic peak.
In vivo measurements
For in vivo measurements, a different type of annu-
lar array transducer, four-element, operating at 3.5 MHz
in Doppler mode and 4 MHz in B-scan mode, 1.15 cm in
diameter, and 4.7 cm in focal length, was used to mea-
sure the carotid artery of a 25-y-old male subject, from
52° to 80° beam-vessel angle. The beam-vector angle
and flow velocity were calculated in the chosen part in
the measured spectra (as shown in Fig. 4A). The GE-
VingMed 750 can provide 18 spectra within 0.12 s in the
chosen part of the measured spectra.
In a human subject’s carotid artery measurements,
the longitudinal direction of the carotid artery was first
manually set using a vessel axis marker on the B-scan
ultrasound image. The vessel axis and the boundary of
the blood vessel are highlighted by solid line in Fig. 4A.
The Doppler sample volume was set at the center of the
blood vessel and kept at the minimum 1.5 mm. The value
of the reference beam-vessel angle is determined visually
by physicians by aligning the vessel axis marker along
the blood vessel axis. This process may incur some
human errors in determining the value of the reference
beam-vessel angle.
RESULTS
Flow phantom measurements
Figure 3B represents the fmax and fd determined
from the spectrum normalization and averaging process
from 45° to 85° beam-vessel angles (reference angles).
Figure 3C represents the calculated beam-vector angles,
Volume 25, Number 8, 1999
and Fig. 3D represents the beam-vector angle corrected
flow velocities calculated by mode frequencies at the
systolic peak. In Fig. 3B–D, the solid lines represent the
mean values, and the error bars represent the standard
deviations in 12 trials. The standard deviations of calcu-
lated flow velocities in Fig. 3D are lower than 2.8 cm/s,
and the standard deviations of calculated beam-vector
angles in Fig. 3C are lower than 2.2°. In Fig. 3B, fmax and
fd at 85° are overestimated, because the measured Dopp-
ler spectrum is affected significantly by the Doppler
system’s wall filter and most of the Doppler spectra are
filtered out. Therefore, fd are overestimated and (fmax ⫺
fd) are underestimated, so that the beam-vector angle will
be underestimated, as shown in Fig. 3C.
In vivo measurements
The measurements were conducted at different
beam-vessel angles between 52° and 80° in 4° incre-
ments. Figure 4B and C show the calculated beam-vector
angles and the angle corrected flow velocities of a 25-y-
old male in six trials. In Fig. 4B and C, the solid lines
represent the mean values, and error bars represent the
standard deviations. The standard deviations of the
beam-vector angles are lower than 2.2°, as shown in Fig.
4B, and standard deviations of flow velocities are lower
than 12 cm/s, as shown in Fig. 4C.
Figure 5A–C shows the traces of the flow velocities
of a human subject’s carotid artery measured, respec-
tively, at 56°, 68° and 76° beam-vessel angle settings.
The calculated beam-vector angles are 57.5°, 69° and
72.8°, respectively. The three traces represent the flow
velocities calculated without angle correction, with man-
ually set beam-vessel angle correction, and with the
automatic beam-vector angle correction (our method).
The major limitation in spectral Doppler measure-
ments is caused by the Doppler system’s wall filter. It
causes difficulties in measuring slow flow or at large
beam-vector angles. The existence of the wall filter is
essential, but it inevitably filters the lower frequency
portion of the Doppler spectrum. We can observe, in Fig.
5C, that flows measured at large beam-vector angles or
measured during their slow flow region would be af-
fected by the wall filter. Therefore, the spectral Doppler
method is not suitable for large beam-vector angles (larg-
er than 80° in this case) and slow flow velocity (lower
than 18 cm/s) measurements.
DISCUSSION
The best measurement position is at the focus where
the beam has the narrowest width and highest intensity;
the effect of the lateral transit time broadening will be
most salient, and the signal will also be most sensitive. In
modern ultrasound systems, the multiple zone focusing is
 Spectral width Doppler in pulsatile flow ● B.-R. LEE et al. 1225

used in transmitting, and the dynamic focusing is used in

receiving. The measurements do not have to be con-
ducted at the focus. However, if the Doppler sample
volume is set at the focus, not set at the center of a certain
multiple focusing zone, then the lateral transit time
broadening effect will be negatively decreased. Also, the
sensitivity of the measurement will be affected, accord-
ing to the spectrum broadening effect discussed by Ne-
whouse et al. (1987).
The nonstationary effect caused by the flow velocity
acceleration is quite small in this measurement. For
example, in our experiment, the pulsatile flow velocity of
the carotid artery rose from 0.3 m/s to 0.95 m/s in 0.12 s,
corresponding to a less than 25-Hz nonstationary spectral
broadening in the higher frequency portion of spectral
width in our experiment (see Appendix B). In this mea-
surement, the difference between fd and fmax varied from
138 to 415 Hz, so we could neglect the effect caused by
the flow velocity acceleration.
The 1.5-mm sample volume still contained velocity
gradients in the sample volume. However, the fd and fmax
were least affected because the sample volume was po-
sitioned at the center of the vessel (Law et al. 1991).
Velocity gradients in the sample volume affect the spec-
tral broadening effect mostly in the lower frequency
portion of the Doppler spectrum, although the effect is
minimized in the upper frequency portion, as described
by Tortoli et al. (1995). This characteristic also leads to
the choice of using the maximum frequency and the
mode frequency in this measurement method.

CONCLUSIONS
The major assumption of the presented Doppler
spectrum normalization algorithm is that the beam-vec-
tor angle remains unchanged during the chosen part of
the cardiac cycle. Therefore, a consecutive set of Dopp-
ler spectra can be normalized and averaged, even though
these Doppler spectra are obtained from different flow
velocities. The time in the chosen part of the cardiac
cycle is less than 0.12 s. Thus, it could be easily imple-
mented in real time operation with appropriate imple-
mentation.

Fig. 3. (A) Real-time Doppler spectrum of a pulsatile flow in a

flow phantom, with a 33-cm/s systolic peak flow velocity,
measured at 50° beam-vector angle. The spectrum normaliza-
tion window is chosen in the fast flow region (systolic region)
marked by the white dotted bracket. (B) The maximum Doppler
frequency fmax and mode frequency fd measured over different
beam-vessel angle settings. (C) The calculated beam-vector
angles vs. the referenced beam-vessel angles. (D) The beam-
vector angle corrected flow velocity calculated by mode fre-
Fig. 3. quency at the systolic peak.
1226 Ultrasound in Medicine and Biology
Fig. 4. (A) The two-dimensional duplex scan of a carotid artery
measured at a 56° beam-vessel angle setting (AC ⫽ ⫺56°),
with a 1-m/s systolic peak flow velocity. The vessel axis and
the boundary of the blood vessel are highlighted by solid black
lines. (B) The calculated beam-vector angles vs. the manually
set beam-vessel angles. (C) The beam-vector angle corrected
systolic peak flow velocities calculated by mode frequency in
the carotid artery.
Volume 25, Number 8, 1999
Fig. 5. Time traces of the measured flow velocity in a carotid
artery without or with beam-vector angle correction. The man-
ually set beam-vessel angles and the automatically calculated
beam-vector angles are: (A) 56° and 57.5°, (B) 68° and 69° and
(C) 78° and 72.8°.
 Spectral width Doppler in pulsatile flow ● B.-R. LEE et al. 1227

It is worth noting that this simple method only Hein IA. 3-D flow velocity vector estimation with a triple-beam lens
transducer experimental results. IEEE Trans Ultra Ferro Freq Con
measures the sign and magnitude of the beam-vector 1997;44:85– 89.
angle ␪; that is, the magnitude of the transverse flow Law YF, Bascom PAJ, Johnston KW, Vaitkus P, Cobbold RSC.
velocity vector ⱍv⬜ⱍ , and the longitudinal flow velocity Experimental study of the effects of pulsed Doppler sample volume
size and position on the Doppler spectrum. Ultrasonics 1991;29:
vector v//, as shown in Fig. 1. Thus, two arbitrary flows 404 – 410.
VA and VB with the same magnitude of beam-vector Lee BR, Chiang HK, Kuo CD, Lin WL, Lee SK. Doppler angle and
angle ␪ A and ␪ B cannot be distinguished by using this flow velocity estimations using the classic and transverse Doppler
effects. IEEE Trans Ultra Ferro Freq Con 1999;46:252–256.
method. However, this limitation does not affect mea- Newhouse VL, Censor D, Vontz T, Cisneros JA, Goldberg BB. Ultra-
suring the flow velocity in regular blood vessels, in sound Doppler probing of flows transverse with respect to beam
which the blood flows in only one direction. Therefore, axis. IEEE Trans Biomed Eng 1987;34:779 –789.
Newhouse VL, Dickerson K, Cathignol SD, Chapelon JY. Three-
the application of this simple method could successfully dimensional vector flow estimation using two transducers and spec-
measure the beam-vector angle and flow velocity in tral width. IEEE Trans Ultra Ferro Freq Con 1994;41:90 –95.
blood vessels. Tortoli P, Guidi G, Newhouse VL. Improved blood velocity estimation
using the maximum Doppler frequency. Ultrasound Med Biol
In summary, we present a convenient flow velocity 1995;21:527–532.
estimation method, which is accurate, and is also easy to
implement in existing Doppler ultrasound systems. One APPENDIX A
additional advantage of this method is that it can measure
Equation (3) minus eqn (1):
the blood flows not only in the longitudinal scan but also
in the cross-sectional scan. This characteristic enables
␯ W
the measurement of curved blood vessels in which the f max ⫺ f d ⫹ 䡠 䡠 sin ␪ (A1)
␭ F
longitudinal scan is hard to obtain. Future works will
apply this method in renal arteries, hepatic arteries, aorta,
Equation (A1) divided by eqn (1):
etc.
Acknowledgements—Parts of this work were supported by the National f max ⫺ f d W
⫽ 䡠 tan␪ (A2)
Science Council, R.O.C. fd 2䡠F

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␪ ⫽ tan ⫺1 冋 f max ⫺ f d 2 䡠 F
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䡠
W 册 (A3)

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APPENDIX B
In our experiment, the pulsatile flow velocity of carotid artery
rose from 0.3 to 0.95 m/s in 0.12 s. The measured mode frequency fd
rose from 762 to 2287 Hz, and the maximum frequency fmax rose from
900 to 2702 Hz. The higher frequency portion of bandwidth (fmax ⫺ fd)
rose from 138 to 415 Hz. The nonstationary parameter ␤ is:
␤ ⫽ ⌬f d/⌬t, (B1)
where ⌬fd ⫽ (2.287 ⫺ 0.762) ⫽ 1.525 kHz, and kHz, and ⌬t ⫽ 120 ms.
Therefore, the corresponding nonstationary broadening caused by the
flow velocity acceleration was less than 25 Hz (Fish 1991).