Color Doppler method
With the color Doppler method, blood flow towards the probe is displayed red, the flow away from the probe is displayed blue: the brighter the hue, the faster the relative velocity. For gain adjustment of color Doppler imaging, you should raise the gain until noise appears and then decrease it until the noise disappears to make observations and recordings. Adjust without widening the color display area more than necessary because the frame rate is reduced and real time performance falls when it is adjusted too wide.
Left ventricular inflow pattern
The left ventricular inflow pattern is recorded in the apical longitudinal view or the apical 4 chamber view. Try your best to set a view in which the Doppler beam is in parallel with the left ventricular inflow. The position of the sample volume is set at the distal tip of the mitral valve. The left ventricular inflow pattern is used for measurement of early diastolic waves (E-waves), atrial systole wave (A-wave), and deceleration time of E-wave (DcT). You must be careful because the velocity of E- and A-waves and the E/A ratio change when the position of the sample volume is changed. |
Left ventricular ejection flow pattern
As in case of the left ventricular inflow pattern, you must try your best to set a view in which the Doppler beam is in parallel with the ejection flow pattern to record the left ventricular ejection flow pattern. The position of the sample volume is set at the center of the left ventricular outflow tract just below the aortic valve. |
Pulmonary venous blood flow pattern
To obtain the pulmonary venous blood flow pattern, visualize the right pulmonary vein inflow tract from the apical 4 chamber view, lower the speed range of the color Doppler imaging, and set the position of the sample volume 1 - 2 cm inside the inflow part of the pulmonary vein. |
Right ventricular ejection flow pattern
To obtain the right ventricular ejection flow pattern, visualize the longitudinal view of the right ventricular outflow tract and set the position of the sample volume at the center of the right ventricular outflow tract just below the pulmonary valve. The right ventricular ejection flow pattern is used for measurement of the maximum flow rate, the time velocity integrated value, the acceleration time (AcT), and ejection time (ET). |
Mitral annulus velocity pattern
To obtain the mitral annulus velocity flow pattern, visualize the apical 4 chamber view and set the position of the sample volume at the septum or the lateral wall of the mitral annulus. For tissue Doppler imaging, as with the pulse Doppler method, visualize the cross-section where the ultrasound beam is in parallel with the movement of the long axis. Sample volume is set as large as at 5 – 10 mm. The mitral annulus velocity pattern is composed of systolic wave (S'), early diastolic wave (E'), and atrial systolic wave (A'). |