3/12/2017 DopplerUltrasound

Doppler Ultrasound
Test Overview
ADopplerultrasoundtestusesreflectedsoundwavestoseehowbloodflowsthrough
abloodvessel.Ithelpsdoctorsassessthebloodflowthroughmajorarteriesandveins,
suchasthoseofthearms,legs,andneck.Itcanshowblockedorreducedflowof
bloodthroughnarrowareasinthemajorarteriesoftheneck.Thisproblemcouldcause
astroke.Thetestalsocanfindbloodclotsinlegveins(deepveinthrombosis,orDVT)
thatcouldbreaklooseandblockbloodflowtothelungs.Thisproblemiscalleda
pulmonaryembolism.Duringpregnancy,Dopplerultrasoundmaybeusedtolookat
bloodflowinanunbornbabytocheckthebaby'shealth.

DuringDopplerultrasound,ahandhelddeviceispassedlightlyovertheskinabovea
bloodvessel.Thedeviceiscalledatransducer.Itsendsandreceivessoundwaves
thatareamplifiedthroughamicrophone.Thesoundwavesbounceoffsolidobjects,
includingbloodcells.Themovementofbloodcells causesachangeinthepitchof
thereflectedsoundwaves.ThisiscalledtheDopplereffect.Ifthereisnobloodflow,
thepitchdoesnotchange.
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Informationfromthereflectedsoundwavescanbeusedtomakegraphsorpictures
thatshowtheflowofbloodthroughthebloodvessels.Thesegraphsorpicturescanbe
savedandreviewedlater.

ThethreebasictypesofDopplerultrasoundare:

"Bedside"orcontinuouswaveDoppler.Thistypeusesthechangeinpitchofthe
soundwavestoprovideinformationaboutbloodflowthroughabloodvessel.The
doctorlistenstothesoundsmadebythetransducertoassessthebloodflow
throughanareathatmaybeblockedornarrowed.Thistypeofultrasoundcanbe
doneatthebedsideinthehospital.Itusesaportablemachinethatcanquickly
checktheextentofbloodvesseldamageordisease.
DuplexDoppler.Thistestusesstandardultrasoundmethodstomakeapictureof
abloodvesselandtheorgansaroundit.AcomputerturnstheDopplersounds
intoagraph.Thisgraphhelpstoshowthespeedanddirectionofbloodflow
throughthebloodvessel.
ColorDoppler.ColorDopplerusesstandardultrasoundmethodstomakea
pictureofabloodvessel.AcomputerchangestheDopplersoundsintocolors
thatareoverlaidontheimageofthebloodvessel.Thesecolorsshowthespeed
anddirectionofbloodflowthroughthevessel.PowerDopplerisaspecialtypeof
colorDoppler.PowerDopplercangetsomeimagesthatarehardorimpossible
togetusingstandardcolorDoppler.PowerDopplerismostoftenusedtolookat
bloodflowthroughvesselswithinsolidorgans.

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Dopplerultrasoundisdoneto:

Findbloodclotsandblockedornarrowedbloodvesselsinalmostanypartofthe
body.It'smostoftenusedfortheneck,arms,andlegs.
Checklegpainthatmaybecausedbyintermittentclaudication.Thisisa
conditioncausedbyatherosclerosisofthelowerlimbs.
Assessbloodflowafterastrokeorotherconditionthatmightbecausedbya
problemwithbloodflow.Afterastroke ,thiscanbedonewithatestcalled
transcranialDoppler(TCD)ultrasound.
Checkforvaricoseveinsorotherveinproblems.
Mapveinsthatmaybeusedforbloodvesselgrafts.Italsocanlookatthehealth
ofgraftsusedtobypassblockageinanarmorleg.
Findouttheamountofbloodflowtoatransplantedkidneyorliver.
Monitortheflowofbloodafterbloodvesselsurgery.
Findthepresence,amount,andlocationofarterialplaque.Plaqueinthecarotid
arteriescanreducebloodflowtothebrain.Thismayincreasetheriskofstroke
.
Guidetreatmentsuchaslaserorradiofrequencyablationofabnormalveins.
Checkthehealthofafetus .Itmaycheckbloodflowintheumbilicalcord,
throughtheplacenta,orintheheartandbrain ofthefetus .Thistestcan
showifthefetus isgettingenoughoxygenandnutrients.Dopplerultrasound
maybeusedtoguidedecisionsduringpregnancywhen:
Thefetusissmallerthannormalforthegestationalage.Bloodflowthrough
thelargebloodvesselintheumbilicalcord(theumbilicalartery)canbe
lookedat.
Rhsensitizationhasoccurred.Bloodflowthroughabloodvesselinthe
brain canbeusedtocheckthehealthofthefetus.
Themotherhasotherproblems,suchaspreeclampsiaorsicklecell
disease.
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AtranscranialDoppler(TCD)ultrasoundmaybeusedinchildrenwithsicklecell
disease.Thetestcancheckfortheriskofstroke.
How To Prepare

For30minutesto2hoursbeforethetest,youmayneedtostopusingproductsthat
containnicotine.Thisincludescigarettesandchewingtobacco .Nicotinecauses
bloodvesselstonarrow,whichmaygivefalseresults.

How It Is Done

Thistestisdonebyadoctorwhoisanexpertinimagingtests(radiologist).Oritmay
bedonebyanultrasoundtechnologist(sonographer)whoworkswitharadiologist.Itis
doneinanultrasoundroominahospitalordoctor'soffice.

YouwillneedtoremoveanyjewelrythatmightaffecttheDopplerultrasoundscan.You
mayneedtotakeoffallormostofyourclothes,dependingonwhichpartofthebodyis
beingexamined.Youmaybeallowedtokeeponyourunderwearifitdoesnotaffect
thetest.Youwillbegivenaclothorpapercoveringtouseduringthetest.

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Forabdominalscans,youwilllieonyourback.
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Forchestscans,youwilllieonyourbackwithyourneckslightlyextended.
Forheadandneckscans,yourheadmaybeturnedtooneside.
Foranarmorlegscan,yourheadwillbeslightlyraised.Theexposedarmorleg
willbeturnedslightlyoutward.Sometimesforalegscan,youmaybeaskedtolie
onyourstomach.
Duringpregnancy,youwilllieonyourbackoronyourleftsidewithyourbelly
exposed.

Gelisappliedtotheskintohelpthesoundwavespassthrough.Thetransduceris
placedinthegelandmovedalongtheskin.Youneedtolieverystillduringthetest.
Youmayhearsoundsfromtheflowofbloodthroughthebloodvessels.
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Thetestusuallytakes30to60minutes.
Arteries in the arms and legs

Thistestisoftendoneonbotharmsorbothlegs.Evenifthesuspectedbloodflow
problemisinonlyonelimb,bothmaybetestedtocomparethem.Ifyourarmsare
beingtested,theywillbetestedfirstwhileyouliedown.Thenthey'llbetestedagain
whileyousit.

Dependingonwhichbloodvesselsarebeingtested,abloodpressurecuffmaybe
wrappedaroundoneorbothlimbs.Itallowsyourbloodpressuretobetakenatseveral
differentplaces.Whenthelegsaretested,abloodpressurecuffmaybewrappedfirst
aroundthecalfandthenaroundthethigh.Thetestmaybedoneatseveralplaceson
yourleg.Whenthearmsaretested,thepressurecuffmaybewrappedfirstaroundthe
forearmandthenaroundtheupperarm.

Testingmaybedonebeforeandafterexercise,ifyouarehealthyenough.
Veins in the arms and legs

Forthistest,youwillbeaskedtoliedownandbreathenormally.Youmustlieverystill.
Anychangesinbloodflowthatareaffectedbyhowyoubreathearenoted.

Thetestmayberepeatedwhiletheexaminerpressesontheveinsclosetothesurface
ofyourskin.Thishelpstofindaclotinthevein.It'scalledacompressionmaneuver.
Theexaminermaydothismaneuverwithyourlegsorarmsindifferentpositions.This
istomakesurethatthebloodsupplyisnotblockedinthesepositions.Heorshemay
alsosqueezeyourcalf orforearmtohelpbloodmovemorequicklythroughthe
veins.Thisiscalledanaugmentationmaneuver.Itisdonetocheckbloodflowtoward
yourheart .

Whileyourlegsarebeingtested,youmayalsobeaskedtotrytobreatheoutstrongly
withyournosepinchedandyourmouthclosed.ThisiscalledaValsalvamaneuver.It
usuallycausesasuddenchangeinbloodflowthroughtheveins.
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Arteries in the neck

Youwillbeaskedtoliedownwithapillowunderyourheadforsupport.Thetestis
doneonbothsidesofyourneck.Thentheresultsarecomparedtostandardvaluesto

Doppl...
findouthowmuchthearteriesareblockedornarrowed.
Transcranial ultrasound
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Forthistypeofultrasound,thetransducerispassedlightlyovertheskinatthebaseor
sideofyourskull.
During pregnancy

Thetransducerismovedbackandforthonyourbellyuntilthedoctorfindstheblood
vesselthatneedstobestudied.Afterthedoctorhasfoundthebloodvessel,itmay
takesometimetoassessthebloodflow.
How It Feels

HavingaDopplerultrasoundtestdoesn'tnormallycausediscomfort.Thegelmayfeel
coldwhenitisputonyourskinunlessitiswarmedfirst.Ifyourbloodpressureistaken
duringthetest,youwillfeelpressurewhenthebloodpressurecuffisinflated.

Risks

TherearenoknownriskslinkedwithaDopplerultrasoundtest.Thistestwillnotharm
anunbornbaby(fetus).
Results

ADopplerultrasoundtestusesreflectedsoundwavestoseehowbloodflowsthrough
abloodvessel.
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Dopplerultrasound
The test does not show significant narrowing or other problems in any of the arteries.
Normal:

There is no sign of a clot in any of the veins examined. The size and position of veins are
normal.

Normal blood ow is found in the blood vessels that supply oxygen and nutrients to a fetus.

For continuous wave Doppler or duplex Doppler, differences in blood ow between the right
and left sides of the body may be heard. At the exact spot where an artery is blocked or
Abnormal: narrowed, the sound may be high-pitched or turbulent. Blockage (such as from a blood clot),
an aneurysm, or narrowing of a blood vessel may be found. The speed of blood ow may be
compared to standard values to nd out how blocked or narrow the blood vessel is.

A duplex Doppler ultrasound graph may show blood ow that isn't normal. This is a sign of a
blocked or narrowed blood vessel.

A color Doppler image may show a blocked or narrowed blood vessel or an aneurysm.

In the veins, a blood clot may be present if blood ow does not change in response to
breathing or does not increase after either a compression maneuver or Valsalva maneuver.
Incomplete blockage of a vein by a blood clot may be seen on color Doppler or during a
compression maneuver.

Abnormal veins, such as varicose veins, are seen.

There is an abnormal increase or decrease in blood ow through the vessels that supply
oxygen and nutrients to a fetus.

What Aects the Test

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Youmaynotbeabletohavethetest,ortheresultsmaynotbehelpful,if:

Therearebonesabovetheareabeingstudiedorgasintheintestines.Thismay
affectthepictures.
Youarenotabletostaystillduringthetest.
Youareextremelyoverweight.
Youhaveabnormalheartrhythms(arrhythmias)orheartdisease.Thismay
causechangesinbloodflowpatternseventhoughthebloodvesselsarenormal.
Yourarmorlegiscold.Bloodflowthroughthatlimbmaybeslowed.
Youhaveanopenwoundintheareathatneedstobeviewed.
What To Think About

IttakesaskilledexaminertogetaccuratetestresultsforaDopplerultrasound.
Thescansareusuallyreadwithinashortperiodoftimeincaserepeattestsare
needed.
Dopplerultrasoundrequiresapersontoholdverystill,sosomechildrenmay
needtobegivenmedicinetomakethemsleep.Thisisdonesothattheir
movementsdonotaffecttheresults.
AngiographyandvenographyareXrayteststhatuseaninjectedcontrast
material.Inmanycases,Dopplerultrasoundmaybedoneinsteadofthesetests.
Thisisbecauseit'sfaster,costsless,andisnoninvasive.Ifresultsfroma
Dopplerultrasoundareunclear,anangiographyorvenographytestmaybe
done.AngiographyisusuallymoreaccuratethanDopplerultrasound.Itisalso
consideredthemostreliabletestforcheckingthebloodflowthroughanartery.
Magneticresonanceangiography(MRA)andcomputedtomography
angiography(CTA)maybedoneinsteadofregularangiography.That'sbecause
thesetestsarelessinvasiveandeasiertodothanregularangiography.Insome
cases,venographymaybeneededtoconfirmasuspectedveinproblem.
Angiogram
MagneticResonanceAngiogram(MRA)
ADopplerultrasoundmaybeusedtocheckmanybodyorgans.It'salsosafeto
haveitwhenyouarepregnant.
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References

Other Works Consulted

CherneckyCC,BergerBJ(2008).LaboratoryTestsandDiagnostic
Procedures,5thed.St.Louis:Saunders.

FischbachFT,DunningMBIII,eds.(2009).ManualofLaboratoryand
DiagnosticTests,8thed.Philadelphia:LippincottWilliamsand
Wilkins.

PaganaKD,PaganaTJ(2010).MosbysManualofDiagnosticand
LaboratoryTests,4thed.St.Louis:MosbyElsevier.

RomanAS(2013).Latepregnancycomplications.InAHDeCherney
etal.,eds.,CurrentDiagnosisandTreatmentObstetrics&

Doppl...
Gynecology,11thed.,pp.250266.NewYork:McGrawHill.
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Credits
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Credits

ByHealthwiseStaff

PrimaryMedicalReviewerKathleenRomito,MDFamilyMedicine

SpecialistMedicalReviewerHowardSchaff,MDDiagnosticRadiology

CurrentasofAugust21,2015

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