Pulsed Doppler echocardiographic evaluation of the blood stream in children with morphological heart lesion

Echocardiography is well estabished as a valuable method for detecting specific lesions and is useful for obtaining information which is helpful in the management of many patients with congenital and acquired abnormalities of the heart and great vessels (1-9). However, conventional M-mode and two-dimensional echocardiographic techniques are not always diagnostic since some acquired and congenital cardiac disorders result in nonspecific echocardiographic findings (10-11). Range gated pulsed Doppler (RGPD) is a diagnostic approach supplementing M-mode echocardiography in identifying blood-flow patterns at well defined intracardiac sampling areas of interest. The sample areas may be selected at any depth from 2 to 15 centimeters along the ultrasonic beam in order to localize information from a specific zone in a known cardiac cavity or from a great vessel. By demonstrating that intracardiac flow is either laminar or non-laminar, conclusions can be made as to what structural abnormality exists. The purpose of this investigation was to determine the sensitivity and limitations of range gated pulsed Doppler echocardiography as a method to distinguish children with different forms of cardiac malformations. Precautions were taken to be as blind as possible to the diagnosis. The studies to be presented have in part been published previously (12-18). Their detailed review and interrelation form the basis of this work