PSAX Doppler

Question 1

What is the order of images for PXAS doppler?

Answer 1

1. Optimized 2D
2. Optimized colour doppler
3. Optimized spectral doppler (PW, CW)

Question 2

What is the PSAX base routine order? 5

Answer 2

1. AV colour
2. TV colour
3. TV CW (+/- TR Jet mmts)
4. PV colour
5. MV Colour

Question 3

What are some things to remember when you get a PSAX AV colour image? 3

Answer 3

1. Zoom
2. Colour box slightly wider than AV annulus
3. If there is regurgitation is present, You should see it here.

Question 4

When you zoom on PSAX AV colour what should you see?

Answer 4

A bit around the AV too

Question 5

What are some tips to get the PSAX PV image? 2

Answer 5

1. Same as PSAX but we’re centring the valve
2. Start with a good 2D image

Question 6

If we are getting a PSAX RV inflow image, and we can’t see the valve opening what does this mean?

Answer 6

We are not going to see the TR jet

Question 7

What are some things we need to remember when we get a PSAX TV colour clip? 4

Answer 7

1. Sector down
2. Sweep and assess for TR
3. Colour box just as wide as annulus
4. Keep FR up!

Question 8

What should we remember when we get a PSAX TV CW clip? 3

Answer 8

1. Place the cursor through centre of TR jet, TV coaptation zone if no TR
2. Baseline 1/4 from top with 2.4 m/sec below baseline even if no TR is seen
3. Measure if parabolic jet seen

Question 9

Should we measure the the TR?

Answer 9

Yes because we can see the peak

Question 10

Should we measure this TR?

Answer 10

No because we would be guessing. See how the furies is right in the blue jet?

Question 11

How normal is it for TR?

Answer 11

80% of us have TR

Question 12

What are some tips we should remember for PSAX PV colour?

Answer 12

1. Make the colour box just wide enough
2. Sweep and assess PV
3. PV colour can also be done in PSAX

Question 13

For a PSAX RVOT/PV Spectral doppler what do we need to show? What will we see if it is available?

Answer 13

1. Pulmonary regurgitation
2. RVOT

Question 14

For PSAX RVOT/PV spectral doppler why do we need to see pulmonary regurgitation? And what do we need to do if we see it?

Answer 14

1. We want to find higher velocities if they are there.
2. CW

Question 15

For PSAX RVOT/PV spectral doppler what should we see in the RVOT? What should we do with it? And what do we use?

Answer 15

1. We will see slower velocities,
2. This means we want to sample the RVOT using PW

Question 16

For a PSAX RVOT PW image we need to look for a PV “closing click” what should these look like?

Answer 16

These are the really thing lines under the baseline

Question 17

What should the SV measure on the RV side of the PV?

Answer 17

~ 5mm

Question 18

For PSAX RVOT PW what should we measure?

Answer 18

Peak velocity or trace VTI

Question 19

For PSAX RVOT PW we need to assess what?

Answer 19

The RV outflow velocity, because many congenital abnormalities result in an increase in velocity in this area

Question 20

On the PSAX RVOT PW image, if PV has regurgitation what do we do?

Answer 20

It is ignored for PW because optimization of spectral should be on forward flow

Question 21

What will the PSAX RVOT PW also be used for in terms of calculation?

Answer 21

RV stroke volume calculation

Question 22

What do we measure for PSAX PV CW image?

Answer 22

Peak velocity, these are found in vessels screen of calc packages

Question 23

Where should the baseline be for PSAX PV CW image?

Answer 23

Baseline should be near top

Question 24

How should we adjust scale for PSAX PV CW?

Answer 24

Adjust scale to waveform seen

Question 25

What do we use CW for on a PSAX CW PV image? 2

Answer 25

We use it Interrogate the PV for 1. Pulmonary valve stenosis 2. Pulmonary valve regurgitation

Question 26

What are some PV non-routine measurements? 3

Answer 26

1. Pulmonary acceleration time (PAT) 2. PR end-diastolic velocity 3. PR peak velocity

Question 27

What do we use Pulmonary acceleration time?

Answer 27

to calculate mPAP

Question 28

What do we use PR end- diastolic velocity?

Answer 28

To calculate PAEDP

Question 29

What do we use PR peak velocity for?

Answer 29

To calculate mPAP

Question 30

What should we remember in terms of getting a PSAX MV colour image? 3

Answer 30

1. Colour box only slightly wider than MV 2. Keep FR high 3. Sweep and assess MV

Question 31

For a PSAX MV colour image, if we see MR what does this mean?

Answer 31

It means that we probably seen it in the PLAX image

Question 32

Why should we sweep the APEX?

Answer 32

Sweeping all the way to the apex in PSAX will allow you to detect this muscular ventricular septal defect (VSD), which sits at the apex