An investigation of simulated umbilical artery Doppler waveforms. II. A comparison of three Doppler waveform quality indices

Three Doppler waveform quality indices based upon assessment of the noise of the maximum frequency envelope of simulated umbilical artery waveforms were investigated. These indices were: an estimate of the correlation between successive waveforms (QI1), a local linearity measure (QI2) and a ratio of two regions of the Fourier transform amplitude spectrum of the maximum frequency envelope (QI3). Simulated umbilical artery waveforms were acquired from a physiological flow phantom. A test population was used consisting of a large number of waveforms where one of three physical variables had been adjusted to produce waveforms of varying quality. These three physical variables were: beam-vessel angle, beam-vessel axial misalignment and attenuator thickness. For this group of waveforms the accuracy of estimation of the maximum frequency envelope and pulsatility index (PI) were known. All three quality indices gave good separation of high- and low-quality waveforms based upon threshold values of the accuracy of PI and maximum frequency envelope. The dependence of each quality index on fetal breathing, waveform length and waveform pulsatility was investigated. QI2, the local linearity measure, showed most promise in its independence from these variables.