Left ventricular (LV) blood flow is an inherently complex time-varying 3-D phenomenon, where 2-D quantification often ignores the effect of out-of-plane motion. In this study, we describe high frame rate 4-D echocardiographic particle image velocimetry (echo-PIV) using a prototype matrix transesophageal transducer and a dynamic LV phantom for testing the accuracy of echo-PIV in the presence of complex flow patterns. Optical time-resolved tomographic PIV (tomo-PIV) was used as a reference standard for comparison. Echo-PIV and tomo-PIV agreed on the general profile of the LV flow patterns, but echo-PIV smoothed out the smaller flow structures. Echo-PIV also underestimated the flow rates at greater imaging depths, where the PIV kernel size and transducer point spread function were large relative to the velocity gradients. We demonstrate that 4-D echo-PIV could be performed in just four heart cycles, which would require only a short breath-hold, providing promising results. However, methods for resolving high velocity gradients in regions of poor spatial resolution are required before clinical translation.

The design of 3D TEE transducers poses severe technical challenges: channel count, electronics integration with high and low voltages, heat dissipation, etc. We present an adult matrix TEE probe with separate transmit (Tx) and receive (Rx) arrays allowing optimization in both Tx and Rx [1]. Tx elements are directly wired out, Rx employs integrated micro-beamformers in low-voltage (1.8/5.0V) chip technology. The prototype is fully integrated into a gastroscopic tube.