Don and all, The distal renal artery when in doubt with close to a 10-0 cos angle in sagittal or long axis is best imaged in a transverse or transverse oblique view with the patient in a r or lt decubitus position... There are always two ways to look at renal arteries. And for supine vs decubitus position for renal arteries, visualization is your best predictor of RAS. You should always take your highest velocity from the 2 positions. If you do it correct you will be right every time. The toughest call I had to make recently was double renal arteries bilateral and both 80-99% stenosed. Deseased renal arteries can mirror with your color satuaration up. But we were correct looked exactly like the angio that put the patient into 25% renal capacity. Now trust your velocity if you do them correctly. You have to stay parellel to the wall and look at them in supine as well as decubitus for every study. Please read up on the literature published and it will help. Remember vascular is better than MRI angio. Denise Levy, RVT San Jose, CA

On 9/15/07, JASON ROBERTS <[log in to unmask]> wrote:
Don, It does only if you can obtain it at zero degrees. If you can obtain it at zero why shift to the 45? Im my opinon ( and its not much) the AP angles tend to be closer to 60, and the flank zero. With this said, what if you can not insonate the full artery from the flank and closer to zero due to limitations. And the only obtainable signal is from the midline and at 60, is the study invalid? I think its a tit for tat question. If all the other factors apply, post stenotic turbulece, SRT, and as N. Garbani pointed out whats the difference between 300 and 350 cm sec in the abdomin, nothing!! Just a point to argue.
Jason

> Date: Sat, 15 Sep 2007 09:26:01 -0700
> From: [log in to unmask]
> Subject: Re: Those darn Doppler angles again
> To: [log in to unmask]
>
> Let me clarify:
>
> You're getting the distal renal artery from the flank approach, and the true angle is pretty much 0 degrees regardless of changes of approach. Does setting the cursor at 45 degrees not overestimate velocity?
>
> To be sure, you want to see the localized acceleration and turbulence; this is just a point of technique.
>
> Thanks,
>
> Don
>
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