Jugular Venous Diameter Measurement Using A-Mode Ultrasound: A Feasibility Study

Abstract

Jugular Venous Pulse (JVP) has significant clinical importance in the screening and early detection of various cardiovascular anomalies. Although the conventional state-of-the-art B-mode imaging systems can perform reliable acquisition of JVP signals, additional complex computations and system requirements are necessary to process the acquired signals. Most clinical-grade B-mode systems are expensive and bulky, limiting their large-scale field usability. To meet the needs of a portable, easy-to-use, field amenable system, we propose an image-free A-mode ultrasound system for JVP acquisition. In this work, we have investigated the feasibility of performing A-mode JVP acquisition and its diameter measurements' reliability against a reference B-mode imaging system. An in-vivo study was conducted on 25 healthy human volunteers in the 20–30 age group. The A-mode system permitted reliable acquisition of frames with $\text{SNR} > 20\ \text{dB}$, by real-time monitoring of the visual feedback. It was observed that repeatable and reliable pulses that concur with the physiologically expected JVP morphology were captured. The beat-to-beat variability of the Jugular venous (JV) diameter was found to be less than 4%. The linear regression analysis revealed that the diameter measurements by the developed system were strongly correlated to the reference values ($\mathrm{r} > 0.85,\ \mathrm{p} < 0.05$). There was no significant bias in the Bland-Altman analysis between the A-mode and reference systems. The study findings indicate that the proposed A-mode system could acquire high-fidelity JVP signals, which can further be processed using intelligent algorithms to predict vascular health. We have observed that the developed system can provide reliable and repeatable measurements of JV diameter and has a potential for large-scale field studies.