The importance of the Doppler angle.
We examined 118 infrainguinal grafts (103 patients) to determine the effect changes in the angle of theta or Doppler angle had on the accuracy of velocity measurements made with a duplex scanner. Four separate measurements of peak velocity were made on each graft. Three measurements were made with the flow toward the probe at 60 degrees, 50 degrees, 120 degrees (60 degrees the other way). The probe was then turned 180 degrees so the flow was away from the probe and measurements were made at 60 degrees. When the primary cursor was aligned with the vessel wall (Technologist A), the mean velocity at 60 degrees was 69.4 cm/sec and 57.3 cm/sec at 50 degrees, a difference of 12 cm/sec. The same measurements done by Technologist B (primary cursor non aligned with the wall), showed a 10 cm/sec difference (60.7 and 50.5). We saw a consistent difference with even this small difference in the angle of theta throughout the study. The mean velocity obtained by Technologist A when the flow was toward the probe was 61.7. When the probe was turned 180 degrees (flow away from the probe), the mean velocity was 60.5. The same measurements by Technologist B were 51.8 and 50.5. This indicates that the direction of the flow of blood towards or away from the probe does not effect the velocity measurements. Using the vessel wall to line up the primary cursor provides a consistent and easily reproducible reference point to compare measurements made on different days but is less important for single measurements.
Nanda
R
R
Columbia Metrowest Medical Center, Framingham, MA, USA.
Unger
C V
CV
Janisko
J
J
Persson
A
A
D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001783:Blood Flow Velocity; D001807:Blood Vessel Prosthesis; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D015203:Reproducibility of Results; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*