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					| Doppler Ultrasound
		
			| Test OverviewA Doppler
		  ultrasound test uses reflected sound waves to see how
		  blood flows through a blood vessel. It helps doctors assess the blood flow
		  through major arteries and veins, such as those  of the arms, legs, and neck. It can show
		  blocked or reduced flow of blood through narrow areas in the major arteries of the
		  neck. This problem could cause a
		  stroke. The test also can find blood clots in leg veins
		  (deep vein thrombosis, or DVT) that could break loose
		  and block blood flow to the lungs. This problem is called a pulmonary embolism. During pregnancy, Doppler ultrasound may be
		  used to look at blood flow in an unborn baby to check
		  the baby's health. During Doppler ultrasound, a handheld
		  device  is passed lightly over the skin above a blood vessel.
		  The device is called a transducer. It sends and receives sound waves that are amplified through a
		  microphone. The sound waves bounce off solid objects, including blood cells.
		  The movement of blood cells causes a change in the pitch of the reflected sound
		  waves. This is called the Doppler effect. If there is no blood flow, the pitch does
		  not change.  Information from the reflected sound waves can be used to make graphs or pictures that show the flow of blood through
		  the blood vessels. These graphs or pictures can be saved and reviewed later.  The three basic types of Doppler ultrasound
		  are: "Bedside" or continuous wave Doppler. This type
			 uses the change in pitch of the sound waves to provide information about blood
			 flow through a blood vessel. The doctor listens to the sounds made by the
			 transducer to assess the blood flow through an area that may be blocked or
			 narrowed. This type of ultrasound can be done at the bedside in the hospital. It uses a portable machine that can quickly check the extent of blood
			 vessel damage or disease.Duplex Doppler. This test uses
			 standard ultrasound methods to make a picture of a blood vessel and the
			 organs around it. A computer turns the Doppler sounds into a graph. This graph helps to show the speed and direction of blood flow through the
			 blood vessel.Color Doppler. Color Doppler uses standard
			 ultrasound methods to make a picture of a blood vessel. A computer
			 changes the Doppler sounds into colors that are overlaid on the image of the
			 blood vessel. These colors show the speed and direction of blood flow through
			 the vessel. Power Doppler is a special type of color Doppler. Power Doppler can get some images that are hard or impossible to
			 get using standard color Doppler. Power Doppler is most often used to
			 look at blood flow through vessels within solid organs.
Why It Is DoneDoppler ultrasound is done to: Find blood clots and blocked or narrowed
			 blood vessels in almost any part of the body. It's most often used for the neck, arms, and
			 legs.Check  leg pain
			 that may be caused by
			 intermittent claudication. This is a condition caused by
			 atherosclerosis of the lower
			 limbs.Assess blood flow after a stroke or other condition
			 that might be caused by a problem with blood flow. After a stroke, this can
			 be done with a test called transcranial Doppler (TCD)
			 ultrasound.Check for varicose veins or other vein problems.Map veins that may be used for blood vessel grafts. It also can
			 look at the health of grafts used to bypass blockage in an arm or
			 leg.Find out the amount of blood flow to a transplanted kidney or
			 liver.Monitor the flow of blood after blood vessel
			 surgery.Find the presence, amount, and location of arterial
			 plaque. Plaque in the carotid arteries can reduce
			 blood flow to the brain. This may increase the risk of stroke.Guide
			 treatment such as laser or radiofrequency ablation of abnormal
			 veins.Check the health of a fetus. It may check blood flow in the
			 umbilical cord, through the
			 placenta, or in the heart and brain of the fetus. This test can show if the fetus is getting enough oxygen and
			 nutrients. Doppler ultrasound may be used to guide decisions during pregnancy
			 when: 
			 The fetus is smaller than normal for the
				  gestational age. Blood flow through the large blood
				  vessel in the umbilical cord (the umbilical artery) can be looked
				  at.Rh sensitization has occurred. Blood flow through a
				  blood vessel in the brain  can be used to
				  check the health of the fetus.The mother has other problems, such as
				  preeclampsia or
				  sickle cell disease. 
 A transcranial Doppler (TCD) ultrasound may be used in
		  children with sickle cell disease. The test can check for the risk of stroke. How To PrepareFor 30 minutes to 2 hours
		  before the test, you may need to stop using products
		  that contain nicotine. This includes cigarettes and chewing tobacco. Nicotine causes blood vessels to narrow, which may give false
		  results.How It Is DoneThis test is done by a doctor who is an expert in  imaging tests (radiologist). Or it may be done
		  by an ultrasound technologist (sonographer) who works with a radiologist.
		  It is done in an ultrasound room in a hospital or doctor's office. You will need to remove any jewelry that might affect the Doppler
		  ultrasound scan. You may need to take off all or most of your clothes, depending on which part of the body is being examined. You may be allowed to keep on your
		  underwear if it does not affect the test. You will be given a cloth or
		  paper covering to use during the test. For abdominal scans, you will lie on your
			 back.For chest scans, you will lie on your back with your neck
			 slightly extended.For head and neck scans, your head may be turned
			 to one side.For an arm or leg scan, your head will be slightly
			 raised. The exposed arm or leg will be turned slightly outward. Sometimes
			 for a leg scan, you may be asked to lie on your stomach.During
			 pregnancy, you will lie on your back or on your left side with your belly
			 exposed.
 Gel is applied to the skin to help the
		  sound waves pass through. The transducer is placed in the gel and moved along the skin. You
		  need to lie very still during the test. You may hear sounds from
		  the flow of blood through the blood vessels. The test usually
		  takes 30 to 60 minutes. Arteries in the arms and legsThis test is often
			 done on both arms or both legs. Even if the suspected blood flow problem
			 is in only one limb, both may be tested to compare them. If your arms are being
			 tested, they will be tested first while you lie down. Then they'll be tested again while
			 you sit. Depending on which blood vessels are being
			 tested, a blood pressure cuff may be wrapped around one or both limbs. It allows
			 your blood pressure to be taken at several different places. When the
			 legs are tested, a blood pressure cuff may be wrapped first around the calf and then
			 around the thigh. The test may be done at several places on your leg. When
			 the arms are tested, the pressure cuff may be wrapped first around the forearm and
			 then around the upper arm. Testing may be done before and after
			 exercise, if you are healthy enough. Veins in the arms and legsFor this test, you will
			 be asked to lie down and breathe normally. You must lie very still. Any changes
			 in blood flow that are affected by how you breathe are
			 noted. The test may be repeated while the examiner presses on the
			 veins close to the surface of your skin. This  helps to find a clot in the vein. It's called a compression maneuver. The examiner may do this maneuver with your legs or
			 arms in different positions. This is to make sure that the blood supply is not blocked in
			 these positions. He or she may also squeeze your calf or forearm to help
			 blood move more quickly through the veins. This is called an augmentation maneuver.
			 It is done to check blood flow toward your heart. While your
			 legs are being tested, you may also be asked to try to breathe out strongly
			 with your nose pinched and your mouth closed. This is called a
			 Valsalva maneuver. It usually causes a
			 sudden change in blood flow through the veins. Arteries in the neckYou will be asked to lie down
			 with a pillow under your head for support. The test is done on both
			 sides of your neck. Then the results are compared to standard values to
			 find out how much the arteries are blocked or narrowed. Transcranial ultrasoundFor this type of
			 ultrasound, the transducer is passed lightly over the skin at the base or side
			 of your skull. During pregnancyThe transducer is moved back and
			 forth on your belly until the doctor finds the blood vessel that needs to be
			 studied. After the doctor has found the blood vessel, it may take some time to
			 assess the blood flow.How It FeelsHaving a Doppler ultrasound test doesn't normally cause discomfort. The gel may feel cold when it is put on
		  your skin unless it is warmed first. If your blood pressure
		  is taken during the test, you will feel pressure when the blood pressure cuff
		  is inflated.RisksThere are no known risks linked with a
		  Doppler ultrasound test. This test will not harm an unborn baby (fetus).ResultsA Doppler
		  ultrasound test uses reflected sound waves to see how
		  blood flows through a blood vessel. Doppler ultrasound| Normal: | The test does not show
					 significant narrowing or other problems in any of the arteries. | 
|---|
 |  | There is no sign of a clot
					 in any of the veins examined. The size and position of veins are
					 normal. | 
|---|
 |  | Normal blood flow is found in
					 the blood vessels that supply oxygen and nutrients to a
					 fetus. | 
|---|
 | Abnormal: | For continuous wave Doppler or
					 duplex Doppler, differences in blood flow between the right and left sides of
					 the body may be heard. At the exact spot where an artery is blocked or
					 narrowed, the sound may be high-pitched or turbulent. Blockage (such as from a
					 blood clot), an
					 aneurysm, or narrowing of a blood vessel may be
					 found. The speed of blood flow may be compared to standard values to find
					 out how blocked or narrow the blood vessel is. | 
|---|
 |  | A duplex Doppler ultrasound
					 graph may show blood flow that isn't normal. This is a sign of a blocked or narrowed blood
					 vessel. | 
|---|
 |  | A color Doppler image may show
					 a blocked or narrowed blood vessel or an aneurysm. | 
|---|
 |  | In the veins, a blood clot may
					 be present if blood flow does not change in response to breathing or does not
					 increase after either a compression maneuver or
					 Valsalva maneuver. Incomplete blockage of a vein by a
					 blood clot may be seen on color Doppler or during a compression
					 maneuver. | 
|---|
 |  | Abnormal veins, such as
					 varicose veins, are seen. | 
|---|
 |  | There is an abnormal increase or decrease in blood flow through the
					 vessels that supply oxygen and nutrients to a fetus. | 
|---|
What Affects the TestYou may not be able to
		  have the test,  or the results may not be helpful, if: There are bones above the area being studied or gas in
			 the intestines. This may affect the pictures.You are not able to stay still during the
			 test.You are extremely overweight.You have abnormal heart rhythms
			 (arrhythmias) or heart disease. This may cause changes in blood flow patterns
			 even though the blood vessels are normal.Your arm
			 or leg is cold. Blood flow through that limb may be slowed.You have an open
			 wound in the area that needs to be viewed.
What To Think AboutIt takes a skilled examiner to get accurate test results for a Doppler
			 ultrasound. The scans are usually read within a
			 short period of time in case repeat tests are needed.Doppler ultrasound requires a person to hold very still, so some children may need to be given medicine to make them sleep. This is done so that their movements do not affect the
			 results.Angiography and venography are
			 X-ray tests that use an injected
			 contrast material. In many cases, Doppler ultrasound
			 may be done instead of these tests. This is because it's faster, costs less, and is noninvasive. If results from a Doppler ultrasound are
			 unclear, an angiography or venography test may be done. Angiography is
			 usually more accurate than Doppler ultrasound. It  is also considered the most
			 reliable test for checking the blood flow through an artery. Magnetic resonance
			 angiography (MRA) and computed tomography angiography (CTA) may be done instead
			 of regular angiography. That's because these tests are less invasive and easier to
			 do than regular angiography. In some cases, venography may be needed
			 to confirm a suspected vein problem.A
			 Doppler ultrasound may be used to check many body organs. It's also safe to have it when you are pregnant.
ReferencesOther Works ConsultedChernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.Roman AS (2013). Late pregnancy complications. In AH DeCherney et al., eds., Current Diagnosis and Treatment Obstetrics & Gynecology, 11th ed., pp. 250-266. New York: McGraw-Hill.
CreditsByHealthwise StaffPrimary Medical ReviewerKathleen Romito, MD - Family Medicine
 Adam Husney, MD - Family Medicine
 Specialist Medical ReviewerHoward Schaff, MD - Diagnostic Radiology
Current as ofJanuary 4, 2017Current as of:
                January 4, 2017 Last modified on: 8 September 2017  |  |  |  |  |  |