Modeling error in ultrasound tissue Doppler measurement due to incorrect transducer placement

Correct placement of the ultrasound transducer when performing echocardiography is recognized as an important and difficult skill for the sonographer to master, especially when performing myocardial contrast echocardiography (MCE). In the current study we have made a mathematical model of the left ventricle where the ultrasound transducer can be freely placed, and we show that a severely misplaced transducer can produce images and tissue velocity measurements easily mistaken for good. We also show that although the erroneous scan plane is difficult to identify, an orthogonal plane will reveal that the ultrasound transducer is misplaced. Hence, we urge for the manufacturing of biplanar ultrasound transducers to simplify the transducer placement and to guide the sonographer through the examination.