An investigation was made into the effect of acquisition parameters on the distension waveform estimated from tissue Doppler imaging (TDI). Physiological distension waveforms were generated using a compliant wall phantom. Distensions derived over a range of scanning geometries and transducer pressures were compared with those obtained in optimised scanning conditions. The estimated maximum distension decreased with scanning depth by 7% between 20 mm and 44 mm below the phantom surface, with an increase in transducer-vessel angle (by 22% from 0 degrees to 24 degrees ) and with a decrease in scan plane-vessel coincidence (by 34% from coincidence to 2 mm from the vessel central axis). An increase with transducer pressure was observed (by 20% from contact to high exerted pressure).