Abdominal Doppler

Question 1

What does pulsed wave doppler do?

Answer 1

• measures velocity of fluid in a vessel
• pos or neg doppler shift based on motion between media and transducer

Question 2

What is Nyquist limit?

Answer 2

top limit of scale, max value wave can show

Question 3

What is aliasing?

Answer 3

when top value of wave is over the Nyquist limit, shows on the bottom of the scale

Question 4

What are indications for abdominal doppler?

Answer 4

• cirrhosis
• portal HTN
• portal vein thrombosis
• TIPS eval
• liver transplant
• Budd-Chiari

Question 5

How should a normal splenic vein appear on doppler?

Answer 5

• tail toward transducer
• head away from transducer
• continuous flow
• low velocity
• above baseline

Question 6

How should the hepatic artery appear on doppler?

Answer 6

• hepatopetal, pulsatile flow
• high velocity, ~100 cm/s
• above baseline

Question 7

How should MPV appear on doppler?

Answer 7

• hepatopetal, monophasic flow
• low velocity, between 20-40 cm/s
• above baseline
• respiratory phasicity

Question 8

How should LPV appear on doppler?

Answer 8

• monophasic flow
• above baseline
• divides into med & lat branches
• appears as red branch off MPV

Question 9

How should RPV appear on doppler?

Answer 9

• monophasic flow
• below baseline
• divides into ant & post branches
• appears as blue branch off MPV

Question 10

How do LHV, MHV, RHV appear?

Answer 10

• triphasic flow
• respiratory phasicity
• below baseline

Question 11

What is the sono app of portal HTN?

Answer 11

• enlarged MPV diam (>13 mm)
• collaterals
• splenomegaly
• ascites

Question 12

What is the doppler appearance of portal HTN?

Answer 12

• hepatopetal, slow hepatofugal
• low velocity, continuous flow
• bidirectional flow
• recanalized umb vein
• lack of respiratory variation
• decreased velocity, <20 cm/s, can increase w recanalized umbv

Question 13

How can portal HTN be treated?

Answer 13

Transjugular Intrahepatic Portasystemic Shunt (TIPS)
- reduces PV pressure & variceal bleeding
- usually RPV to RHV or MHV
- doppler analysis req

Question 14

What is the sono app of PV thrombosis?

Answer 14

• increased HA flow
• partial/total occlusion of MPV
• echogenic thrombus
• collaterals

Question 15

What are the symptoms of PV thrombosis?

Answer 15

• asymptomatic (chronic)
• ascites
• splenomegaly
• GI bleed
• intestinal ischemia (acute)

Question 16

What is the sono app of cirrhosis?

Answer 16

• best diagnosed with elasto
• nodular contour, coarse
• enlarged caudate, IVC compression

Question 17

What is the doppler app of cirrhosis?

Answer 17

• MPV flow reversal
• low MPV velocity
• increased pulsatility
• turbulent color pattern

Question 18

What does positive or negative doppler shift refer to?

Answer 18

The direction the blood flow of the vessel is moving in reference to the transducer, positive = toward

Question 19

Where do we look at the wave form during pulse wave?

Answer 19

In the spectral window that shows up on spectral analysis

Question 20

How should the gate be placed?

Answer 20

In the middle of the vessel in the section that you want to sample, should be parallel and match the angle of the vessel

Question 21

What should you adjust before doppler?

Answer 21

Scale, baseline, color gain

Question 22

What do we need to do with the gate for any artery?

Answer 22

use angle correct

Question 23

Which vessels appears to travel away from the transducer at the porta hepatis?

Answer 23

RPV

Question 24

Which vessels require a velocity measurement for a liver doppler exam?

Answer 24

MPV, HA

Question 25

Venous flow is typically how many phases?

Answer 25

monophasic

Question 26

Monophasic flow in an artery means

Answer 26

there is pathology