Podcast
Questions and Answers
What should you do to demonstrate turbulent flow in the presence of stenosis?
What should you do to demonstrate turbulent flow in the presence of stenosis?
Why is it recommended to keep the PW gate at approximately 1/3 the vessel size during Doppler sample gate imaging?
Why is it recommended to keep the PW gate at approximately 1/3 the vessel size during Doppler sample gate imaging?
How does a stenosis affect blood flow proximal to it?
How does a stenosis affect blood flow proximal to it?
Which law can be applied to understand how a stenosis affects blood flow?
Which law can be applied to understand how a stenosis affects blood flow?
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What happens if the Doppler gate is too large for the vessel during imaging?
What happens if the Doppler gate is too large for the vessel during imaging?
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How does velocity change at the stenosis according to the Bernoulli Effect?
How does velocity change at the stenosis according to the Bernoulli Effect?
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What impact does high Doppler gain have on the appearance of a waveform?
What impact does high Doppler gain have on the appearance of a waveform?
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'Spectral broadening' in a Doppler waveform occurs due to...
'Spectral broadening' in a Doppler waveform occurs due to...
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'High resistance waveform' proximal to a stenosis is characterized by...
'High resistance waveform' proximal to a stenosis is characterized by...
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At what point along a vessel would you expect to find 'elevated PSV and EDV' according to the text?
At what point along a vessel would you expect to find 'elevated PSV and EDV' according to the text?
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Study Notes
Ultrasound Basics
- Reflection: angle of incidence does not matter, results in unclear boundaries and shadowy appearance
- Scattering: occurs at small interfaces, size equal to one wavelength, creates softer reflections and appearance
- Rayleigh's scattering: when interface is smaller than one wavelength, scattered reflections are equal in all directions
Refraction
- Occurs when sound beam changes direction or bends between mediums
- Requires oblique incidence and different propagation speeds
- Snell's Law: relates incident angle and refracted angle when mediums have different propagation speeds and oblique incidence
- Critical angle: when US beam is extremely oblique, no transmission of sound
Pulsed Ultrasound
- Generates pulses of 2-3 cycles only
- Pulse echo principle: sends pulse, waits for echo, and uses listening time to know location of reflection
- PRF (pulse repetition frequency): depends on depth, inversely related to depth
- PRP (pulse repetition period): time between beginning of one pulse to beginning of the next pulse, includes listening time
Shadowing and Enhancement
- Shadowing: helpful tool to identify calcified structures, increases with frequency
- Posterior enhancement: caused by lack of attenuation, produces brighter echoes posterior to fluid-filled objects
- Edge shadowing: dropout or shadowing at lateral edges of a round structure, caused by refraction
Artifacts
- Double image: caused by refraction, produces two images side by side
- Beam width artifact: loss of lateral resolution along the beam width, echoes appear as horizontal lines
- Ways to fix artifacts: change angle, spatial compounding
Blood Flow and Vessel Dynamics
- Bernoulli Effect: describes relationship between pressure and velocity at a change in vessel radius or diameter
- Pressure and velocity are inversely related
- Types of blood flow: laminar, parabolic, plug, and turbulent
- Laminar flow: organized, concentric streamlines, spectral window in waveform
- Parabolic flow: highest velocities in center of vessel, lowest next to wall
- Plug flow: all layers move at the same velocity
- Turbulent flow: abnormal, disorganized flow, often seen distal to stenosis
Doppler Ultrasound
- Doppler sample gate: should be kept at approximately 1/3 the vessel size
- Gate too large: spectral broadening, waveform appears disorganized
- Gate too small: waveform appears normal
- Doppler gain: too high, color "bleeds" out of vessel, underestimate disease
- Doppler gain: too low, vessel appears not filled in, overestimate disease
Stenosis and Blood Flow
- Proximal to stenosis: decrease in diameter, increase in resistance, high resistance waveform
- At the stenosis: elevated PSV and EDV, velocity increases to maintain volume flow, lowest pressure
- Distal to stenosis: turbulent flow, abnormal flow patterns
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Description
Learn about ultrasound imaging artifacts and scattering phenomena that affect the quality of ultrasound images. Explore how reflections can be scattered in all directions, resulting in softer reflections and unclear boundaries. Understand how Rayleigh's scattering occurs when interfaces are smaller in size.