Deep Abdominal and Pelvic Application of Doppler Color Flow Imaging

Abstract

The uses of Doppler in the abdomen and pelvis include the identification of vessels, the determination of the direction of blood flow, the evaluation of narrowing or occlusion, and the characterization of flow to organs and tumors. Although most of the reported work using pulsed Doppler has emphasized the detection of stenosis and flow disturbances in major vessels, Doppler information may also be valuable in inference of abnormalities in the peripheral vascular bed of an organ or tissue (Fig. 1). Changes in the spectral waveform, or in the case of Doppler color flow imaging (DCFI), in the appearance of flow in diastole, provide insight into the resistance of the vascular bed supplied by the vessel and indicate changes due to a variety of pathologies. In abdominal and pelvic applications, information obtained from both large and small vessels may be of clinical value. For example, large vessel changes such as flow reversal in the portal vein, the presence of portosystemic collaterals, the occlusion of portal, splenic, or renal veins, and mesenteric or renal artery stenosis are all identifiable by ultrasonographic methods. Small vessel changes reflecting the impedance of the vascular bed may also be important in the early identification of rejection of transplanted organs and may aid in differentiation of benign from malignant masses.