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What is doppler ultrasound?
A doppler ultrasound is a diagnostic test which uses high frequency sound waves to evaluate the blood while it flows through blood vessel. This allows doctors to see what’s going on inside your body without X-rays or injections and provides detailed analysis of blood flow through major arteries and veins of arms, leg and neck. Test also reveals the blockages/clots or reduced flow of blood in the major arteries.
It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism).
This test has replaced x-ray methods such as angiography, as a method to evaluate blood vessels and blood flow. In general, it allows real-time view of blood flow that cannot be obtained by other methods.
Doppler ultrasound has proved a boon in all areas of ultrasound, aiding in the evaluation of the major arteries and veins of the body, the heart, and in obstetrics for fetal monitoring.
In doppler ultrasound a handheld device known as transducer is passed lightly over the skin just above the blood vessels. The sound waves sent by transducer are amplified through a microphone. These sound waves bounce when they come in contact with solid objects (including blood cells).
The pitch of the sound waves (Doppler effect) changes due to movement of blood cells. When there is no blood flow the pitch does not change.
These sound waves are processed by computer to provide pictoral or graphical representation of blood flow through the blood vessels. These images can be transmitted digitally and also be saved for future reference.
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What are different types of doppler ultrasound?
The different types of doppler ultrasound are :-
1. Color Doppler:
The color doppler test uses normal ultrasound method to provide pictures of blood vessels. But the doppler sounds are converted into colors with the help of computer. These colours are then overlaid on the image of the blood vessel and it represents the speed and direction of the blood flow within the vessel.
2. Duplex Doppler:
Duplex doppler test uses standard ultrasound method to produce a image of blood vessel and surrounding organs. The Doppler sounds are converted with the help of computer into a graph that provides information about the speed and direction of blood flow through the blood vessel being evaluated.
3. Power Doppler:
This is the latest ultrasound technique which is five times more sensitive in detecting blood flow if compared to colour doppler. In particular, this test is capable to capture images that are difficult to capture with normal colour doppler. This test is normally used to evaluate blood flow through vessels within solid organs. Blood flow in individual blood vessels is evaluated by combining colour doppler with duplex doppler. This combination not only provides better information on the direction but also the speed of blood flow.
4. “Bedside” or continuous wave Doppler:
This type of doppler uses the change in pitch of the sound waves to provide information about blood flow through the blood vessel. With these sound the doctor gets information about the blocked or narrowed blood flow within that area. Moreover, this type of doppler ultrasound can be done at the bedside in the hospital to provide rapid estimate of the blood vessel damage or disease.
What is a Venous Doppler?
A venous Doppler ultrasound is a diagnostic test used to check the circulation in the large veins in the legs (or sometimes the arms) for any blockage in the veins by a blood clot or thrombus formation.
What is an Arterial Doppler?
An arterial doppler is an ultrasound exam of the arteries located in your arms or legs. High frequency sound waves are used to obtain images of structures inside the body. Ultrasound imaging can help the radiologist see and evaluate arterial blockages, such as plaque in arteries.
What is a vein mapping study?
Ultrasound is performed to create a “map” of your leg veins for the surgeon in preparation for various procedures that will include bypass graft surgery (For Instance, replacing diseased vessels in your body with the healthy vein from your leg).
What is the difference between normal ultrasound and Doppler ultrasound?
The main difference is that a with Doppler ultrasound shows blood flow whereas a regular ultrasound uses sound waves to produce images, but can’t show blood flow.
When is Doppler ultrasound done?
A Doppler ultrasound test uses reflected sound waves to see how blood flows through a blood vessel. Doppler is done to helps doctors assess the blood flow through major arteries and veins. A reduced amount of blood flow may be due to a blockage in the artery, a blood clot inside a blood vessel, or an injury to a blood vessel.
Doppler ultrasound is mainly done to:
• Find blood clots and blocked or narrowed blood vessels in almost any part of the body. Moreover, it’s 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.
• Deep vein thrombosis (DVT), a condition that occurs when a blood clot forms in a vein deep inside your body (usually in the leg or hip regions)
• Assess blood flow after a stroke or other condition that might be caused by a problem with blood flow
• Check for varicose veins or other vein problems.
• Map veins that may be used for blood vessel grafts.
• Find out the amount of blood flow to a transplanted kidney or liver.
• Monitor the flow of blood after blood vessel surgery.
• A Doppler ultrasound can help determine the blood pressure within your arteries. It can also show how much blood is currently flowing through your arteries and veins.
• Find the presence, amount and location of arterial plaque. Plaque in the carotid arteries can reduce blood flow to the brain. Moreover, this may increase the risk of stroke.
• Guide treatment such as laser or radiofrequency ablation of abnormal veins.
• Check the health of a foetus. It may check blood flow in the umbilical cord, through the placenta or in the heart and brain of the foetus.
This test can show if the foetus is getting enough oxygen and nutrients.
Abnormal blood flow patterns, including narrowing or closing of the arteries, can indicate:
* Blockage in the arteries, which may be due to a buildup of cholesterol
* Blood clots in a vein or artery
* Poor circulation, which can be caused by damaged blood vessels
* Venous occlusion, or closing of a vein
* Spastic arterial disease, a condition in which the arteries contract due to stress or exposure to cold weather
* Blockage or clots in an artificial bypass graft
How is doppler ultrasound done?
You may be asked to avoid products like cigarettes, chewing tobacco for 30 minutes to 2 hours before the test as they contain nicotine. In fact, nicotine causes blood vessels to constrict and may give false results.
If you are diabetic, you need to tell your doctor before Doppler ultrasound.
You might be required to remove any jewellery or any metal object that might interfere with the doppler ultrasound scan. You may need to wear loose and comfortable clothes or a gown. For abdominal and chest scans you are required to lie on your back, for head/neck scan your head may be turned to one side and for arm or leg scan your head is slightly raised and the exposed arm or leg is turned slightly outward.
The test is performed by radiologist who specializes in performing and interpreting images of the test. Gel is applied on the skin to facilitate the penetration of sound waves. The transducer is placed in the gel and moved along the skin. You are required to remain still during the entire procedure so that clear images are captured.
Once the test is done, you wipe the gel from your body, and you’re ready to resume your normal routines.
By and large, the test is normally completed in 30-45 minutes.
• It is a low cost test without any radiation..
• Doppler ultrasound can be used to generate highly accurate blood flow data.
• Accurate Doppler ultrasound could delay the costly follow-up angiogram until it is really necessary.
In short, there are no known risks associated with a Doppler ultrasound test. In fact, this test is very safe, painless and doesn’t use any type of radiation.
The amount of time it takes for you to get your results will differ depending on where you get your scans done. Accordingly, the radiology doctor will look at the pictures and prepare a report. The pictures may be on films or on a CD.
If you had the test done to check for deep vein thrombosis (DVT) , doctor would tell you what the images show about your blood flow and tell you the next steps to be taken henceforth. If you do have a clot, you may have more than one Doppler ultrasound over a few days to see whether the clot grows or any new ones show up.
• There is no sign of a clot in any of the veins examined. The size and position of veins are normal.
• The test does not show significant narrowing or other problems in any of the arteries.
• Normal blood flow is found in the blood vessels that supply oxygen and nutrients to a fetus.
• A duplex Doppler ultrasound graph may show blood flow that isn’t normal. This is a sign of a blocked or narrowed blood vessel.
• 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.
• A colour Doppler image may show a blocked or narrowed blood vessel or an aneurysm.
• 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.
• 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 manoeuvre or Valsalva manoeuvre. Incomplete blockage of a vein by a blood clot may be seen on colour Doppler or during a compression manoeuvre.
The results may not be clear due to following reasons:
• You are not able to stay still during the test.
• There are bones above the area being studied or gas in the intestines. This may affect the image quality.
• 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.
Your doctor will need to discuss the report with you and depending on the report will advice you on further steps required.
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