Intro to Doppler (Ch 7, pp519-538, 552-561) Doppler Effect: an apparent shift in frequency of an interrogating wave.

The cause = relative motion between observer and an object. The shift = a change in wavelength (due to motion) changes the Frequency the sound propagating from the moving source results in a compression of the wavefronts towards Observer B and a decompression of the wavefronts relative to Observer A. Therefore, Observer A hears a lower pitch than the transmitted wave and Observer B hears a higher pitch than the transmitted wave.

4 + 1 Factors that contribute to determining the Doppler shift: 1. Relative Direction: ve or +ve (directly away or directly towards) 2. Velocity (c) of moving structure (RBCs) 3. Operating Frequency or transmit: reflections from RBCs are Rayleigh scatter, therefore the returning signal is dependent on the transmit frequency- a higher transmit frequency will be able to detect a higher Doppler shift 4. Velocity of sound in the medium: Propagating Velocity (c) Factor # 5: Angle of insonation/incidence, i.e. Angle to flow: we want an angle as close to parallel (0o or 180o) to provide an accurate Doppler shift

f Dop

2 f ov cos c

Parallel Doppler angle is important for: Flow direction Measurement accuracy/Potential errors Potential artifact (such as spectral broadening)

Spectral Doppler- displays a range of frequency shifts (related to a range of velocities through the Doppler equation) on the verticle axis and time on the horizontal axis. Variations in flow characteristics are visualized, such as spectral broadening, turbulence, and laminar flow (pg 1017, Meile) Amplitude/Returning signal strength is determined by the # RBCs being sampled at a specific point, and is represented by the brightness of the spectral Doppler trace. Modalities: Pulsed Wave A Doppler technique which uses pulses to achieve range specificity. Doppler gate size (SVB) and depth is set by the user. The system produces a pulse that matches the gate size and waits the appropriate time for the sound wave to travel to the desired gate depth and return. By restricting the pulse length, signals are primarily received from the depth of interest (pg. 1015, Meile) Continuous Wave A Doppler technique which measures the Doppler shifted frequencies by transmitting and receiving waves continuously and simultaneously. CW has the advantage of unlimited maximum detectable frequency shifts and no aliasing, but lacks range specificity (pg. 1007, Meile)

Colour Doppler A scanned technique based on the Doppler principles which allows for flow assessment over a 2-D region. Flow information is assessed using a colour scale. The colour representation is an estimate of the mean/average velocity at each location for that instant in time. (pg 1006, Meile)

Tissue Doppler A Doppler technique that measures the much lower Doppler shifting, yet still moving myocardial motion. Myocardial motion information is assessed using a colour scale. The colour representation is an estimate of the mean velocity of the relative motion. This motion can also be plotted onto a spectral Doppler tracing to provide more specific information.

Power Doppler/Angio Doppler A Doppler technique that measures the amplitude of the returning echo signal, rather than the Doppler shift and relative direction and velocity. It is angle independent, and provides information on the presence of blood flow and returning signal strength/amplitude only.

Flow Types: Laminar (eg, normal LVOT) - Spectral Window Turbulent (eg, Tricuspid Regurg.) - Spectral Broadening

Nyquist Limit: the highest detectable Doppler frequency shift without aliasing; limited by the PRF (sampling rate); Nyquist= PRF 2 x Maximum Dop