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Doppler ultrasound is technique for making non-invasive velocity blood flow measurement U\S measures Doppler frequency shift between transducer and the red blood cells Christian Doppler was the first to describe the frequency shift that occurs when sound or light is emitted from a moving source. DOPPLER SHIFT Doppler shift is difference between transmitted and received frequencies. U/S is transmitted into vessel and sound that is reflected from blood is detected. Because blood is moving, sound undergoes a frequency shift k\a Doppler shift. A stationary blood cell reflects the incoming wave with the same wavelength so there is no Doppler shift A blood cell moving away from the probe reflects the incoming wave with a longer wavelength In reality, there are actually two Doppler shifts. The first one occurs between the probe and the moving blood cell and the second one occurs as the red blood cell reflects the ultrasound. DOPPLER EFFECT Doppler Effect is the change in the frequency (or wavelength) of any emitted waves, such as a wave of light or sound as the source of the wave approaches or moves away from an observer Higher frequency = blood towards transducer Lower frequency = blood away from transducer

Resting sound source

f s =o f

Sound source moving toward observer

fo >s f

Sound source moving away from observer

USES OF DOPPLER Determination of anatomy. Determination of small vessel flow distribution. Detection of vascular dilatation, obstruction. Evaluation of intravascular disease.

fo <s f

Detection of extra vascular flow. TYPES OF DOPPLER Continuous wave Doppler Seldom used, not a/v in most AED machines Without B MODE imaging Use two crystals, one to send and one to receive. Doppler signals are obtained from all vessels in the path of the ultrasound beam Evaluates very high velocities (good temporal resolution) because PRF essentially infinite Use is essentially limited to cardiology and anesthesia monitoring Maximum detectable Doppler Shift not limited for continuous wave Doppler Pulsed wave Doppler The transducer both sends and receives the signal. The returned signal is gated so that only information about the desired depth is computed. Usually a duplex display is used Pulsed Doppler ultrasound is a technique for measuring the velocity of blood in a small sample volume Used in general & obstetric ultrasound & also used to provide data for Doppler sonograms & color flow images. Disadvantage Aliasing as maximum detectable Doppler Shift is limited for pulsed instruments Its important to correct in pulse Doppler so accurate measurements can be made Color Doppler A fairly large gate is analyzed and the Doppler shift is depicted as shades of color Traditionally, shades of red are reflectors moving toward the transducer, blue away Velocity is encoded as a color Aliasing is important to correct in color Doppler because it is easily mistaken for turbulence Duplex Doppler Putting Color Doppler on top of Grey-scale B mode Power Doppler Power Doppler is somewhat more sensitive, but generally throws out directional information of the whole image (Doppler equivalent of B-mode) DOPPLER ARTIFACTS Doppler spectrum speckle Random constructive & destructive interference from sound scattered in blood Aliasing Occurs because sampling rate too slow Results in detection of improper flow direction Maximum detectable Doppler shift equals half the pulse repetition frequency Happens for the same reason that wagon wheels appear to turn the wrong way in old movies The computer assumes a baseline and a range (determined by PRF) Coping with Aliasing When you are looking at high-flow structures, this throws out garbage movement like that associated with respiration or the pulsation of vessel walls Can control aliasing by decreasing transducer frequency increasing pulse repetition frequency increasing Doppler angle Angle Correct Cursor Angle correct is needed to convert the Doppler frequency to a reflector velocity Operator adjusts the cursor parallel to the flow direction

Machine then computes the Doppler angle thru equation Frequency shift = 2 f ( / c) cos

The computer does not know the incident angle unless you tell it It will assume an angle of 0 in its calculations We very, very seldom interrogate vessels at this angle Angle correction does NOT need to be performed if you are going to plug the velocity measurement into an equation where the units drop out