Renal Doppler Protocol
Structure
RT Kidney
Scan Plane
Sagittal
LABEL
RT KIDNEY MID
SAG
RT Segmental
Renal Artery
Sagittal
RT SEGMENTAL
RA SUPERIOR
RT Segmental
Renal Artery
Sagittal
RT SEGMENTAL
RA MID
RT Segmental
Renal Artery
Sagittal
RT SEGMENTAL
RA INFERIOR
RT Main Renal
Artery
Transverse
At Hilum
RT MAIN RA
AT HILUM
RT Renal Vein
(if indicated)
Transverse
At Hilum
RT RENAL VEIN
AT HILUM
RT Main Renal
Artery
RT Main Renal
Artery
Aorta at the
level of the RA
Aorta at the
level of the RA
LT Kidney
Transverse
Mid
Transverse
At Origin
Sagittal
RT MAIN RA
MID
RT MAIN RA
AT ORIGIN
AORTA
Sagittal
Landmarks Identified
 Right Kidney mid
 Renal sinus
 Liver
 Right Kidney mid
 Renal sinus
 Liver
 Right Kidney mid
 Renal sinus
 Liver
 Right Kidney mid
 Renal sinus
 Liver
 Right Kidney mid
 Renal sinus
 Liver
 Right Kidney mid
 Renal sinus
 Liver
 Mid right main RA



Mid aorta
Origin of right RA
Mid aorta
AORTA

Mid aorta
Sagittal
LT KIDNEY MID
SAG
LT Segmental
Renal Artery
Sagittal
LT SEGMENTAL
RA SUPERIOR
LT Segmental
Renal Artery
Sagittal
LT SEGMENTAL
RA MID
LT Segmental
Renal Artery
Sagittal
LT SEGMENTAL
RA INFERIOR
LT Main Renal
Artery
Transverse
At Hilum
LT MAIN RA
AT HILUM
LT Renal Vein (if
indicated)
Transverse
At Hilum
LT RENAL VEIN
AT HILUM
LT Main Renal
Artery
LT Main Renal
Artery
Transverse
Mid
Transverse
At Origin
LT MAIN RA
MID
LT MAIN RA
AT ORGIN



















Left Kidney mid
Left sinus
Spleen
Left Kidney mid
Left sinus
Spleen
Left Kidney mid
Left sinus
Spleen
Left Kidney mid
Left sinus
Spleen
Left Kidney mid
Left sinus
Spleen
Left Kidney mid
Left sinus
Spleen
Mid left main RA


Mid aorta
Origin of left RA
Cw/backup/protocol/renal Doppler protocol 13
Images Stored
Gray Scale
Gray Scale with measurement
Color Doppler
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Gray Scale
Color and Spectral Doppler with peak
systolic velocity measurement
Gray Scale
Gray Scale with measurement
Color Doppler
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler with
measurement
Color and Spectral Doppler
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Color and Spectral Doppler with ESP,
AT and peak systolic measurement
Renal Doppler Protocol
Anatomical/Image Correlation
ESP
ESP = Early Systolic Peak
AT = Acceleration time or rise time
V
V= Velocity
AT
Renal Doppler Protocol
Tips

Scan through the kidney first
Color Doppler




Will vary with the presence/absence of pathology & curvature of the vessel
Color images should relay the same information as your Gray scale & Spectral images
Utilize preset Color PRF (scale) and adjust according to the

If large amount of color outside or blooming in center of vessel increase PRF

If vessel is not filled in decrease PRF
Color box should be steered (angled) with vessel direction
Spectral Doppler
 Must use angle correct-Angle correct must be less than 60 degrees
 Gate (SV length) must be in center of vessel & small width
 Adjust your PRF (scale) to display a large waveform that has a clear spectral window and measure the
highest velocity
 Set the PRF(scale) appropriately for the velocities imaged

If the PRF is set too high with velocities well below the maximum, this may result in the
automatic velocity detection selecting a mirror image waveform rather than the true waveformavoid this by reducing your PRF
Cw/backup/protocol/renal Doppler protocol 13
Renal Doppler Protocol
Plaque Present (surface irregularities)
 Document plaque in transverse & sagittal planes
 Do not adjust your gray scale (TGC) to display a complete anechoic vessel
 Demonstrate blood flow around plaque with Color Doppler
 Stenosis
 A mosaic of color will be displayed
 Evaluate stenosis with Spectral Doppler for highest velocity by placing cursor in the stenotic area
 Record and measure highest velocity
 Record velocities in normal area of vessel approximately 2cm prior (pre-stenotic) and after (poststenoic) the area of stenosis
 Significant stenosis is considered if the flow in stenotic area is twice the velocity of an
area just previous (pre-stenotic flow) to it
What do the ratios indicate
Normal Peak Systolic velocity (PSV) is 74 – 127 cm/sec in adults and children
Renal PSV DIVIDED by Aorta PSV = ratio
Chart for stenotic findings
PSV
180 cm/sec
Renal/Aortic
Ratio
Greater than
3.3-3.5
Damping of
intrarenal
arteries
Present
Cw/backup/protocol/renal Doppler protocol 13
Acceleration
Index
Acceleration
Time
Less than 300
cm/sec
Greater than
0.07 second
Degree of
Stenosis
Significant
stenosis of
60% or
more