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ECNU - CCE Examination > Color Flow And Doppler > Flashcards

Color Flow And Doppler Flashcards

1
Q

Doppler Physics

Frequency shifted ____ by approaching target.

A

Up

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2
Q

Doppler Physics

Frequency shifted ____ by receding target.

A

Down

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3
Q

Is the degree of frequency shift proportional to velocity?

A

Yes

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4
Q

What are the modes of Doppler signal processing and display?

(Three)

A
  • Doppler frequency spectrum
  • Color flow
  • Power mode
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5
Q

What is the Doppler Effect?

A

The apparent change in the frequency of a wave caused by relative motion between the source of the wave and the observer.

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6
Q

What color is the Doppler when moving towards the target?

A

Blue

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7
Q

What color is the Doppler when moving away from the target?

A

Red

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8
Q

What are the two main uses of Doppler in thyroid ultrasonography?

A
  • Vascular (imaging and flow analysis of blood vessels)

- Vascularity of tissue

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9
Q

Doppler can be used to see vascularity of tissue to determine what four things?

A
  • Probability of Malignancy
  • Graves’ vs Thyroiditis
  • Amiodarone Thyrotoxicosis
  • Image Clarification
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10
Q

Spectral Doppler

What are the three types of velocities used for calculations?

A
  • Peak systolic velocity
  • End diastolic velocity
  • Mean velocity
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11
Q

Resistive Index = …

A

(Peak systolic velocity - end diastolic velocity) / peak systolic velocity

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12
Q

Pulsatility Index = …

A

(Peak systolic velocity - End diastolic velocity) / Mean velocity

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13
Q

What color is the power Doppler setting?

A

Different shades of red

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14
Q

What kind of information does color Doppler provide?

A

Provides information regarding direction and velocity.

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15
Q

What kind of studies is color Doppler more useful in?

A

Vascular studies

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16
Q

Does power Doppler give any information regarding velocity?

A

No

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17
Q

Does power Doppler have more or less angle dependence compared to color Doppler?

A

Less angle dependence

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18
Q

Does power Doppler have more or less noise compared to color Doppler?

A

Less noise

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19
Q

Does power Doppler have increased or decreased sensitivity for detection of flow compared to color Doppler?

A

Increased sensitivity for detection of flow.

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20
Q

Name one issue with Doppler usage?

A

User variability

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21
Q

How many grades are there on the Doppler grading scale?

A

4

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22
Q

Grading Scale:

1

A

Absent vascularity

rare with modern equipment

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23
Q

Grading Scale:

2

A

Mostly peripheral vascularity

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24
Q

Grading Scale:

3

A

Peripheral greater than intranodular

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25
Q

Grading Scale:

4

A

Predominantly intranodular

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26
Q

Approximately what percentage of cancers have an intra-nodular vascular pattern?

A

74%

27
Q

When is ultrasound guided fine needle aspiration recommended based on risk factors?

A

If independent risk factors are present.

28
Q

What is recommended if no high risk features are present on ultrasound examination?

A

Follow-up with clinical and ultrasound evaluation.

29
Q

Which has a better negative predictive value when predicting malignancy?

Power Doppler or color Doppler…?

A

Power Doppler

30
Q

What is more frequently seen in malignant nodules…

Vascularity or no vascularity?

A

No vascularity

31
Q

Benign or malignant?

Taller than wide?

A

Malignant

32
Q

Which type of thyroid cancer may power Doppler be predictive of?

A

Follicular cancer

33
Q

Dense fibrosis is seen in ______ % of papillary carcinoma.

A

56 - 89%

34
Q

Which type of blood flow is the only ultrasound feature predictive of cancer (follicular)?

A

Internal blood flow

35
Q

Is there any significant correlation between the color Doppler pattern and the malignancy rate of solid round isoechoic nodules?

A

No significant correlation

36
Q

What is the most important variable (on ultrasound) significantly associated with follicular neoplasms?

A

Irregular margins

37
Q

Is the negative predictive value of Doppler sufficient to obliterate the need for FNA biopsy?

A

No

38
Q

Which has greater sensitivity and is able to detect lower degrees of internal flow…

Color Doppler or Power Doppler?

A

Power Doppler

39
Q

What is type 1 amiodarone-induced thyrotoxicosis?

A

Graves’ disease like hyperthyroidism - in patients with pre-existing thyroid abnormality.

40
Q

How is type 1 amiodarone-induced thyrotoxicosis treated?

A

Thionamides and perchlorate.

41
Q

Type 1 amiodarone-induced thyrotoxicosis…

Vascularity?

A

Normal or increased vascularity

42
Q

What is type 2 amiodarone-induced thyrotoxicosis?

A

Destructive thyroiditis-like thyrotoxicosis

43
Q

Type 2 amiodarone-induced thyrotoxicosis…

Vascularity?

A

Absent vascularity

44
Q

How is type 2 amiodarone-induced thyrotoxicosis treated?

A

Glucocorticoids

45
Q

Which interleukin is often elevated in type 2 amiodarone-induced thyrotoxicosis?

A

Interleukin 6

46
Q

Does type 1 or type 2 amiodarone-induced thyrotoxicosis cause elevated interleukin 6?

A

Type 2 amiodarone-induced thyrotoxicosis

47
Q

Amiodarone-induced thyrotoxicosis.

Is the response rate to prednisone better when color Doppler flow is absent or present?

A

Absent

48
Q

Amiodarone-induced thyrotoxicosis.

What should you treat the patient with when color Doppler flow is absent?

A

Prednisolone

49
Q

Amiodarone-induced thyrotoxicosis.

What should you treat the patient with when color Doppler flow is present?

A

Thionomides and perchlorate.

50
Q

Amiodarone-induced thyrotoxicosis.

What should you treat the patient with if they are unresponsive to your initial treatment?

A

Combination therapy / surgery

51
Q

When an interface is moving with respect to the reflected sound wave, the frequency of the reflected sound is altered.

True or false?

A

True

52
Q

What is the peak systolic velocity in ‘thyroid inferno’?

A

8 - 20 cm/sec

53
Q

What is the peak systolic velocity in ‘thyrotoxicosis factitia’?

A

3 - 5 cm/sec

54
Q

What is ‘thyrotoxicosis factitia’?

A

Minimal intrathyroidal vascular flow in thyrotoxicosis

55
Q

Destructive thyroiditis usually has low vascularity.

True or false?

A

True

56
Q

What is the ‘gold standard’ to diagnose the etiology of thyrotoxicosis?

A

Radioactive iodine uptake

57
Q

In normal nodes where do vessels enter?

A

Centrally at the hilus

58
Q

In normal nodes, which axis do vessels spread along?

A

The long axis

59
Q

Where do vessels enter malignant nodes?

A

Enter peripherally in the node capsule.

60
Q

Benign or malignant?

Increased or disordered vascularity seen peripherally and centrally in the lymph node.

A

Malignant

61
Q

Which two settings increase sensitivity for detection of low flow (when doing Doppler of nodes)?

A
  • Low wall filter

- Low pulse repetition frequency

62
Q

Which glands have polar arteries?

A

Parathyroid glands

63
Q

Does lack of flow in a follicular lesion make malignancy more or less likely?

A

Less likely

64
Q

Is vascularity relevant in lesions suspicious for papillary thyroid carcinoma?

A

No

ECNU - CCE Examination (13 decks)

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