Color Doppler
Digital radiography is a form of X-ray imaging...
How should I prepare?

You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined. You may be asked to wear a gown during the procedure. If your abdominal vessels are being examined, unless the examination is performed on an urgent basis, it is best to fast before the procedure.

Ultrasound examinations are very sensitive to motion, and an active or crying child can prolong the examination process. To ensure a smooth experience, it often helps to explain the procedure to the child prior to the exam. Bringing books, small toys, music or games can help to distract the child and make the time pass quickly. The ultrasound exam room may have a television. Feel free to ask for your child's favorite channel.

How does the procedure work?

Ultrasound imaging is based on the same principles involved in the sonar used by bats, ships and fishermen. When a sound wave strikes an object, it bounces back, or echoes. By measuring these echo waves, it is possible to determine how far away the object is as well as the object's size, shape and consistency (whether the object is solid or filled with fluid). In medicine, ultrasound is used to detect changes in appearance, size or contour of organs, tissues, and vessels or detect abnormal masses, such as tumors.

In an ultrasound examination, a transducer both sends the sound waves and receives the echoing waves. When the transducer is pressed against the skin, it directs small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off internal organs, fluids and tissues, the sensitive microphone in the transducer records tiny changes in the sound's pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. One or more frames of the moving pictures are typically captured as still images. Small loops of the moving “real time” images may also be saved.

Doppler ultrasound, a special application of ultrasound, measures the direction and speed of blood cells as they move through vessels. The movement of blood cells causes a change in pitch of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and creates graphs or color pictures that represent the flow of blood through the blood vessels.

How is the procedure performed?

For most ultrasound exams, you will be positioned lying face-up on an examination table that can be tilted or moved. A clear water-based gel is applied to the area of the body being studied to help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin that can block the sound waves from passing into your body. The sonographer (ultrasound technologist) or radiologist then places the transducer on the skin in various locations, sweeping over the area of interest or angling the sound beam from a different location to better see an area of concern.

Doppler sonography is performed using the same transducer. When the examination is complete, you may be asked to dress and wait while the ultrasound images are reviewed. This ultrasound examination is usually completed within 30 to 45 minutes. Occasionally, complex examinations may take longer.

What will I experience during and after the procedure?

Ultrasound examinations are painless and easily tolerated by most patients. After you are positioned on the examination table, the radiologist or sonographer will apply some warm water-based gel on your skin and then place the transducer firmly against your body, moving it back and forth over the area of interest until the desired images are captured. There is usually no discomfort from pressure as the transducer is pressed against the area being examined.

If scanning is performed over an area of tenderness, you may feel pressure or minor pain from the transducer. If a Doppler ultrasound study is performed, you may actually hear pulse-like sounds that change in pitch as the blood flow is monitored and measured. Once the imaging is complete, the clear ultrasound gel will be wiped off your skin. Any portions that are not wiped off will dry to a powder. The ultrasound gel does not stain or discolor clothing. After an ultrasound examination, you should be able to resume your normal activities immediately.

Who interprets the results and how do I get them?

A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care physician, or to the physician or other healthcare provider who requested the exam, and he/she will share the results with you. In some cases the radiologist may discuss results with you at the conclusion of your examination.

Follow-up examinations may be necessary, and your doctor will explain the exact reason why another exam is requested. Sometimes a follow-up exam is done because a suspicious or questionable finding needs clarification with additional views or a special imaging technique. A follow-up examination may also be necessary so that any change in a known abnormality can be monitored over time. Follow-up examinations are sometimes the best way to see if treatment is working or if an abnormality is stable over time.

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Benefits vs. Risks
Benefits
Most ultrasound scanning is noninvasive (no needles or injections).
Occasionally, an ultrasound exam may be temporarily uncomfortable, but it is almost never painful.
Ultrasound is widely available, easy-to-use and less expensive than other imaging methods.
Ultrasound imaging is extremely safe and does not use any ionizing radiation.
Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.
Risks
For standard diagnostic ultrasound, there are no known harmful effects on humans.
Limitations of Vascular Ultrasound
Vessels deep in the body are harder to see than superficial vessels. Specialized equipment or other tests such as CT or MRI may be necessary to properly visualize them.
Smaller vessels are more difficult to image and evaluate than larger vessels.
Calcifications that occur as a result of atherosclerosis may obstruct the ultrasound beam.
Sometimes ultrasound cannot differentiate between a blood vessel that is completely occluded (closed off) versus one that is significantly (but not completely) narrowed. Even if there is a very small remaining opening, the weak blood flow produces a sometimes undetectable signal.
The test is specialized and is best performed by a technologist and physician with experience and interest in vascular ultrasound imaging.