Using Spectral Pulsed-Wave Doppler

NOTE: Depending on your membership, probe type and country, Pulsed-Wave Doppler is available in the Vascular: Access, Vascular: Carotid presets, Abdomen, Abdomen Deep, Cardiac, Cardiac Deep, and Cardiac Coherence presets.

Spectral Pulsed-Wave Doppler is a quantitative mode that graphically displays blood flow velocity measurements over time. When using Pulsed Doppler, you can:

View and adjust the position of the sample volume by holding and dragging the gate.
View and adjust the angle correction by holding and dragging the white caliper dot.
Switch between live Pulsed Doppler mode and live B-mode by touching the Start Spectrum/Update B-mode button.
Adjust the gain of the spectral trace by dragging your finger left and right on the trace while the trace is live.
Adjust the Scale to optimize for high or low flow by touching the Low Flow/High Flow control in the middle of the screen. Note that the control defines your current state.
Adjust the Scroll Speed of the Spectral Doppler trace by touching the Slow Scroll/Fast Scroll control in the middle of the screen. Note that the control defines your current state.
If using a Butterfly iQ3, add color to your image by touching the Enable Color Doppler control in the middle of the screen.

In order to adjust the Gain and Depth of the B-mode reference image, exit Pulsed Doppler mode and optimize the image in B-mode.

To use Spectral (Pulsed)-Wave Doppler:

Select your desired preset.
Select the Actions button at the bottom of the screen. Select Pulsed Doppler.
Hold and drag the sample volume gate (the square region in the center of the arrow) to the desired location within the vessel of interest. If using a Butterfly iQ3, you can enable Color Doppler to help with sample volume placement by tapping the Enable Color Doppler button in the middle of the screen.
Once positioned, align the direction of the arrow along the direction of flow. If the flow in the vessel is cranial, point the arrow cranially. If the flow in the vessel is caudal, point the arrow caudally.

Caution: Flow directionality is represented relative to the direction of the arrow. Misalignment of the arrow may lead to misinterpretation of flow direction. Carefully check that the arrow is aligned with the expected blood flow direction.
Note: Flow in the direction of the arrow will always be depicted above the baseline. Flow against the direction of the arrow will always be depicted below the baseline.

Tap “Start Spectrum” to start the spectral trace. If using a Butterfly iQ3, you should hear audio associated with visual trace. The volume can be controlled or muted by adjusting the volume on your device. If you do not hear audio associated with the spectral trace, try increasing the volume on your device.
If you do not see a trace, adjust the position of the sample volume. To adjust the position of the sample volume:

Hold and drag the arrow, which will automatically pause the spectrum and restart the B-mode reference image.
Tap the Update B-mode button to manually pause the spectrum and restart B-mode. If using a Butterfly iQ3, you can toggle Color Doppler on and off after restarting B-Mode.

To adjust the scroll speed of the trace, tap the Slow Scroll/Fast Scroll button.
To adjust the velocity scale, tap the button Low Flow/High Flow button or drag baseline.
To add annotations, freeze the image and tap the annotations button.
To add measurements, freeze the image and select linear measurements.

Note: Annotations and measurements may only be added to the Spectral trace region.

Velocity measurements will be represented in cm/s as Peak Systolic Velocity (PSV), the value of the vertical distance from the baseline first caliper dot, and End Diastolic Velocity (EDV), the value of the vertical distance from the baseline of the second caliper dot.
The difference in time between the left and right ends of the caliper will be represented as time (t) in seconds.
To save a Pulsed Doppler image, freeze then press the capture button.