ECEN 489 – Medical

Instrumentation: Application and

Design
Lecture 7:
Blood Flow and
Volume Measurement
Introduction

• The blood flow can be measured using a few devices: electromagnetic

flowmeter, ultrasonic flowmeter, chamber plethysmography, electrical-
impedance plethysmography and photoplethysmography.

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 Electromagnetic Flowmeters
• It measures instantaneous pulsatile flow of blood.
• An electromotive force (emf) is induced when a conducting wire move through a magnetic field.
• The flowmeter depends on the movement of blood.
• The Faraday’s law for the induced emf:
l
emf = ∫ u ×B • dL
0
where B=magnetic flux density (T)
L=length between electrodes (m)
u=instantaneous velocity of blood (m/s)

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 electrodes

When the blood flows in the vessel with velocity u and passes through the magnetic field, the induced
emf is measured at the electrodes.
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 Electromagnetic Flowmeters
• For a uniform magnetic field and velocity, the induced emf=BLu where the three components
are orthogonal to each other.
• If the sectional area of the lumen of the vessel and average flow velocity are known, the
multiplication of them gives the volumetric flow.
• However, in many locations of blood vessels in the body, the velocity is asymmetric, thus
errors result.

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 DC Electromagnetic Flowmeters
• If a dc magnetic field is used, so the output voltage continuously indicates the flow.
• A few dc flowmeters were built but not satisfactory:
(1) The voltage across the electrode’s metal-to-solution interface is in series with the flow signal. The
random shift of this voltage is of the same order as the flow signal and there is no way to separate the
two.
(2) The ECG has a waveform and frequency content similar to that of the flow signal. Near the heart, the
ECG’s waveform is much larger than that of the flow signal and interference results.
(3) In the frequency range of interest (0-30Hz), the noise in the amplifier is large which results in a poor
SNR.

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 AC Electromagnetic Flowmeters
• The system is operated with an ac magnet current of about 400 Hz.
• The operation of this system results in the ac flow voltage.
• When the flow reverses direction, the voltage changes phase by 180°, so the phase-sensitive demodulator is
required to produce the directional output.
• The problem with ac flowmeter is that presence of transformer voltage.
• This transformer voltage is many times higher than the flow voltage and is 90° out of phase with the flow
voltage.
• The total amplifier voltage is the sum of transformer voltage and flow voltage.

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 Three meth
A few methods can be used to solve this
problem.
(1) The shaded loop is tilted forward or
backward or placed exactly parallel to the
B-field.

q
(2) Sample the signal when the transformer
voltage is zero. At this time, the flow
voltage is at its maximum, and resulting
gated signal measures only the flow
voltage.
(3) Use the quadrature-suppression circuit.

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The magnitude of the voltage in transformer at the amplifier output is detected by the quadrature demodulator, which has a full-
wave-rectified output.
The signal is low-pass-filtered to produce a dc voltage, which is then modulated by the quadrature generator to produce a signal
proportional to the transformer voltage.
The signal is fed to a balancing coil on the input transformer, thus balancing out the transformer voltage at the input.
With enough gain in this negative-feedback loop, the transformer voltage at the amplifier can be reduced by a factor of 50.
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 Ultrasonic Flowmeters what
how
• It can measure the instantaneous blood flow. it will
• The ultrasound can be beamed through the skin, making transcutaneous flowmeters practical.
• There are generally two types of flowmeters: (1) transit time flowmeter, which measures the
velocity difference between upstream and downstream sound waves, (2) Doppler ultrasonic
flowmeter.
• Doppler ultrasonic flowmeter can be continuous wave or pulse wave.
• Continuous wave Doppler ultrasonic flowmeter uses two crystal transducer element, one each
for transmitting and receiving.
• A pulse Doppler system uses a single crystal for both transmitting and receiving.

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Transit Time Flowmeter
θ

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 Transit Time Flowmeters
• The crystals can operate as a transmitter and receiver.
• When measuring the downstream transit time of an ultrasonic pulse, crystal A acts as the transmitter, while
crystal B as the receiver.
• When measuring the upstream time, crystal A acts as the receiver while crystal B as the transmitter.
• The average velocity of the blood can be found using

C 2 ∆T
u=
2 D cos θ
where u is the average flow velocity of the blood, C is the speed of the sound in medium, ΔT is the difference
between upstream and downstream transit times, θ is the angle between the crystal axis and the flow axis.

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 Transit Time Flowmeters

• The ΔT is in the nanosecond range, thus requires complex electronic circuits to achieve
adequate stability.
• Transit Time flowmeters do not require particulate matter for scattering.
• However, they do require invasive surgery to expose the vessel.

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Continuous Wave Doppler Flowmeters

The ultrasound is beamed through the vessel wall, backscattered by the red blood cells, and
received by the piezoelectric crystal

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Continuous Wave Doppler Flowmeter
• The flowmeters detect the blood flow based on the Doppler effect.
• The Doppler effect is a change in frequency of wave when the receiver and transmitter move relatively to
each other.
• The ultrasonic waves are transmitted to the moving blood cells, which reflect the Doppler-shifted waves to
the receiving transducer.
• The amplified radio-frequency (RF) signal plus carrier signal is detected to produce an audio-frequency
(AF) signal.
• The AF signal can be heard on a loud speaker.
• The zero-crossing detector converts the AF input frequency to an analog output signal proportional to the
velocity of the blood cells.

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 Continuous Wave Doppler Flowmeter
• The output of the zero-crossing detector is a series of pulses.
• These pulses are low-pass filtered to remove as many of the high-frequency components as possible.
• A simple frequency-to-voltage converter provides a quantitative output to a recorder.
• The blood flow velocity can be found using
fd c
u=
2 f o cos θ
Where fd is the Doppler frequency shift, fo is the source frequency, u is the blood flow velocity, c is the velocity of
sound.

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 Pulse Wave Doppler Flowmeters
• The transmitter/receiver transmits the ultrasonic waves and receives the reflected signal at a later
time.
• The delay between transmission and reception directly indicates the distance.
• By examining the Doppler shift at various delays, the velocity profile across the vessel.
• To achieve good range resolution, the transmitted-pulse duration should ideally be very short.
• However, in order to achieve a good SNR and good velocity discrimination, it should be long.
• For a 8 MHz pulse, the duration is 1 μs.

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 Chamber Plethysmography what how
• Chamber plethysmographs measure changes in blood volume in a non-invasive way.
• By timing these volume changes, the flow can be determined by computing F = dV/dt.
• Chamber plethysmography is called venous-occlusion plethysmography because a cuff is used to
prevent venous blood from leaving the limb.

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 Chamber Plethysmography
• The chamber has a rigid cylindrical outer container and is place around the leg.
• A calibration is marked on the record by injecting into the chamber a known volume of fluid using the
volume calibration syringe.
• The venous occlusion cuff is then applied to the limb and inflated to 50 mmHg, which prevents venous blood
from leaving the limb.
• The arterial blood flow is not stopped by this cuff pressure and the increase in volume of blood in the limb per
unit time is equal to the arterial inflow.
• If the chamber completely encloses the limb distal to the cuff, the arterial flow into the limb is measured.

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 Chamber Plethysmography
• As the chamber encloses only a segment of a limb, an arterial-occlusion cuff distal to the chamber must be
inflated to 180 mmHg to ensure that the changes in the chamber volume measure only arterial flow entering
the segment of the limb.
• A few seconds after the cuffs are occluded, the venous pressure exceeds 50 mmHg, then the venous return
starts and the volume of the blood in the limb segment saturates.
• When the pressure of the venous-occlusion cuff is released, the volume of blood in the limb segment rapidly
returns to normal.

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Chamber Plethysmography
• If a venous thrombosis (vein clot) partially blocks the return of venous blood, the volume of blood
in the veins returns to normal more slowly (curve).

• The initial volume-versus-time slope is caused by arterial inflow.

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Photoplethysmography (PPG)

• Light can be transmitted through a capillary bed.

• As the arterial pulsations fill the capillary bed, the changes in volume of the vessels modify the
absorption, reflection and scattering of the light.
• PPG is simple and can indicate the timing of events such as heart rate.
•
D
Disadvantages: poor measure of changes in volume, very sensitive to motion artifact.

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 Photoplethysmography (PPG)
• In PPG, there are two methods of light transmission through tissue: finger and aural pinna.

(a) Light transmitted into finger pad is reflected off bone and detected by a photosensor.
(b) Light transmitted through the aural pinna is detected by a photosensor.
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Photoplethysmography (PPG)
• A miniature tungsten lamp may be used as the light source but the heat generated causes
vasodilation (widening of blood vessels).
• A less bulky light source can be formed by using GaAs LED which produces a narrow-band source
with a peak spectral emission at a wavelength of 940 nm.
• Photoconductive cells have been used as sensors but they are bulky and present a problem that prior
exposure to light changes the sensitivity of the cell.
• In addition, a filter is needed to restrict the sensitivity of the sensor to the near-infrared region so
that changes in blood O2 content that are prominent in the visible-light region will not change the
sensitivity.

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 Photoplethysmography (PPG)
• A less bulky photosensor such as Si phototransistor can be used.
• It requires a filter to block the signals from the fluorescent light.
• The output from the sensor represents a large value of transmittance, modulated by very small
changes due to pulsations of blood.

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 Photoplethysmography (PPG)
• To eliminate the large baseline value, frequencies above 0.05 Hz are high-pass filtered.
• The resulting signal is greatly amplified to produce a sufficiently large waveform.
• Any movement of the PPG relative to tissue causes a change in the baseline transmittance that is
many times larger than pulsation signal.

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 Photoplethysmography (PPG)
• These large artifacts (due to motion) saturate the amplifier.
• The switch S is used to short these large artifacts to ground in order to restore the output trace.
• The PPG does not indicate “calibratable” volume changes.
• Its usefulness is limited to pulse-velocity measurements, heart rate and indication of pulse in the
finger.

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