Doppler ultrasound in equine reproduction: principles, techniques, and potential

Doppler ultrasound is an emerging technology that has the potential to increase the diagnostic, monitoring, and predictive capabilities of equine theriogenologists and researchers. The technology is based on Doppler-shift frequencies, wherein the ultrasound frequency of echoes from moving red cells is increased or decreased as the cells move toward or away from the transducer. In spectral mode, the blood flow in a specific vessel can be assessed by placing a sample-gate cursor on the image of the lumen of the vessel. In addition, an angle cursor can be used to represent the angle of intersection of the ultrasound beams with the direction of blood flow (Doppler angle). The Doppler-shift frequency and the Doppler angle are used by the instrument for computing blood velocity. The focused results from placement of a sample gate in an artery are displayed by a spectrum that represents the changing velocities over time in association with the pulses of cardiac cycles. Peak systolic, end diastolic, and time-averaged maximum velocities are computed and shown for a selected cardiac cycle. Doppler indices (resistance index, RI; pulsatility index, PI) are ratios that are computed from various points on the spectrum. The indices are relatable to the hemodynamics of the tissue supplied by the artery. Increasing RI or PI values indicate increasing resistance and decreasing perfusion of the distal tissues. In color-flow mode, Doppler-shift frequencies are obtained from areas delineated by the operator on the B-mode image and are transformed and expressed as color-coded spots representing areas of blood flow. Vascular perfusion of a structure can be quantitated by the number of colored pixels in an image or can be estimated subjectively by the extent of the colored spots. The Doppler technology has the potential for providing information on the status and future success of a structure. However, realization of the expected potential will depend on future experience and research.