Doppler waveforms

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Doppler waveforms are often misinterpreted and/or overlooked. They can provide a great deal of information if carefully understood.

Radiographic features

Ultrasound

Doppler

When interrogating flow with spectral Doppler, the three basic arterial waveforms are ^1,2:

triphasic
- forward flow in systole
- reverse flow in late systole / early diastole
- forward flow in late diastole
biphasic:having two phases or variations having forward and reverse flow ⁷⁵
- reverse flow in diastole
- steady positive flow in the diastole, or
- forward flow in systole
monophasic:single phase with slow (dampened flow) acceleration/deceleration
- low velocity
- high velocity

Triphasic arterial flow is considered normal and monophasic flow is considered abnormal. Most authors consider biphasic flow abnormal, although some authors classify it as a normal waveform ².

Pulsatile venous flow is considered abnormal and is suggestive of elevated pressures in the right atrium ⁸⁶.

-<p><strong>Doppler waveforms </strong>are often misinterpreted and/or overlooked. They can provide great deal of information if carefully understood.</p><h4>Radiographic features</h4><h5>Ultrasound</h5><h6>Doppler</h6><p>When interrogating flow with <a href="/articles/spectral-doppler-ultrasound">spectral Doppler</a>, the three basic arterial waveforms are <sup>1,2</sup>:</p><ul>
+<p><strong>Doppler waveforms </strong>are often misinterpreted and/or overlooked. They can provide a great deal of information if carefully understood.</p><h4>Radiographic features</h4><h5>Ultrasound</h5><h6>Doppler</h6><p>When interrogating flow with <a href="/articles/spectral-doppler-ultrasound">spectral Doppler</a>, the three basic arterial waveforms are <sup>1,2</sup>:</p><ul>
~~-<strong>biphasic</strong>:<strong> </strong>having two phases or variations having forward and reverse flow <sup>7</sup><ul>~~
+<strong>biphasic</strong>:<strong> </strong>having two phases or variations having forward and reverse flow <sup>5</sup><ul>
-</ul><p>Triphasic arterial flow is considered normal and monophasic flow is considered abnormal. Most authors consider biphasic flow abnormal, although some authors classify it as a normal waveform <sup>2</sup>. </p><p>Pulsatile venous flow is considered abnormal and is suggestive of elevated pressures in the right atrium <sup>8</sup>.</p>
+</ul><p>Triphasic arterial flow is considered normal and monophasic flow is considered abnormal. Most authors consider biphasic flow abnormal, although some authors classify it as a normal waveform <sup>2</sup>. </p><p>Pulsatile venous flow is considered abnormal and is suggestive of elevated pressures in the right atrium <sup>6</sup>.</p>

References changed:

4. Rangankar VP, Taori KB, Mundhada RG, Rewatkar AD. Accuracy of Common Femoral Artery Doppler Waveform Analysis in Predicting Haemodynamically Significant Aortoiliac Lesions. Journal of clinical and diagnostic research : JCDR. 10 (2): TC26-8. <a href="https://doi.org/10.7860/JCDR/2016/17732.7326">doi:10.7860/JCDR/2016/17732.7326</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27042558">Pubmed</a> <span class="ref_v4"></span>
5. Scissons R. Characterizing Triphasic, Biphasic, and Monophasic Doppler Waveforms: Should a Simple Task Be So Difficult? Journal of Diagnostic Medical Sonography. 2008. 24(5):269-276. <a href="https://doi.org/10.1177/8756479308323128">doi:10.1177/8756479308323128</a>
6. Abu-Yousef MM, Kakish ME, Mufid M. Pulsatile venous Doppler flow in lower limbs: highly indicative of elevated right atrium pressure. (2013) AJR. American journal of roentgenology. 167 (4): 977-80. <a href="https://doi.org/10.2214/ajr.167.4.8819397">doi:10.2214/ajr.167.4.8819397</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/8819397">Pubmed</a> <span class="ref_v4"></span>
4. Therap Adv Gastroenterol. 2008;5 (5): 371. <a href="http://dx.doi.org/10.1177/8756479308323128">doi:10.1177/8756479308323128</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437532">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22973420">Pubmed citation</a><span class="auto"></span>
5. Chavhan GB, Parra DA, Mann A et-al. Normal Doppler spectral waveforms of major pediatric vessels: specific patterns. Radiographics. 2008;28 (3): 691-706. <a href="http://dx.doi.org/10.1148/rg.283075095">doi:10.1148/rg.283075095</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/18480479">Pubmed citation</a><span class="auto"></span>
6. Rangankar VP, Taori KB, Mundhada RG, Rewatkar AD. Accuracy of Common Femoral Artery Doppler Waveform Analysis in Predicting Haemodynamically Significant Aortoiliac Lesions. Journal of clinical and diagnostic research : JCDR. 10 (2): TC26-8. <a href="https://doi.org/10.7860/JCDR/2016/17732.7326">doi:10.7860/JCDR/2016/17732.7326</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27042558">Pubmed</a> <span class="ref_v4"></span>
7. Characterizing Triphasic, Biphasic, and Monophasic Doppler Waveforms: Should a Simple Task Be So Difficult?. (2008) Journal of Diagnostic Medical Sonography. 5 (5): 371. <a href="https://doi.org/10.1177/1756283X10363751">doi:10.1177/1756283X10363751</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22973420">Pubmed</a> <span class="ref_v4"></span>
8. M M Abu-Yousef, M E Kakish, M Mufid. Pulsatile venous Doppler flow in lower limbs: highly indicative of elevated right atrium pressure. (2013) AJR. American journal of roentgenology. 167 (4): 977-80. <a href="https://doi.org/10.2214/ajr.167.4.8819397">doi:10.2214/ajr.167.4.8819397</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/8819397">Pubmed</a> <span class="ref_v4"></span>