Doppler ultrasound can encounter artifacts that lead to inaccurate flow information representation.
Common artifacts include:
Aliasing: The most prevalent artifact in Doppler ultrasound.
Origin of the term: Comes from Middle English "elles", Latin "alius", and Greek "allos" meaning "other" or "otherwise".
Definition: Indicates improper representation due to insufficient sampling.
Optical temporal aliasing: For example, a wagon wheel appears to rotate differently when filmed at varying frame rates.
The Nyquist limit refers to the maximum detectable Doppler shift frequency by pulsed wave Doppler instruments.
The limit is defined as half the pulse repetition frequency (PRF).
Typical PRF range for Doppler is 5 to 30 kHz.
If Doppler shift exceeds the Nyquist limit, aliasing occurs.
Solutions to aliasing include:
Increase PRF
Change Doppler angle: Increases the angle and decreases the Doppler shift for a given flow.
Baseline shift: Moves the aliased peaks to the correct location without legitimate Doppler shift interference.
Continuous wave Doppler does not experience aliasing but lacks depth localization.
Methods to address aliasing:
Shift the baseline
Increase pulse repetition frequency (PRF)
Increase Doppler angle
Use lower-frequency transducer
Switch to continuous wave operation
Note: Baseline shifting is effective if desired information is not obscured.
Increasing PRF can lead to range-ambiguity:
Occurs when a new pulse is sent before all echoes from the previous pulse are received.
The system cannot differentiate between echoes from the last and previous pulses leading to potential misinterpretation of flow.
A spectral mirror image appears on the opposite side of the baseline for unidirectional flow.
Caused by:
High Doppler gain setting leading to overloading of the amplifier, resulting in leakage (crosstalk) of signals.
Noise: Electronic noise appears if Doppler gains are set too high, leading to speckled appearance in Doppler spectra.
Color Doppler Artifacts:
Similar artifacts as those observed in gray-scale sonography including:
Aliasing: Incorrect flow direction when Doppler shift exceeds Nyquist limit.
Solutions: Adjust flow speed range (PRF increase), baseline shifting to reduce aliasing effects.
Mirror Image Artifact: Similar to spectral displays, can duplicate images across strong reflectors.
Shadowing: Loss of Doppler-shift information beyond an object creating a shadow effect.
Clutter: Results from motion of tissues, heart walls, or valves that obscures true flow representation.
Noise effects: Mimics flow in regions with low echoes, leading to misinterpretation.
Twinkling artifact: Observed at highly reflective surfaces, possibly due to phasing issues in Doppler detection.