Velocity variability in ultrasonic Doppler examinations.

Ultrasonic Doppler examination with spectral waveform has been used for the classification and surveillance of carotid artery stenosis for over 25 years. Progression/regression between examinations can be identified with 95% confidence if the velocity measurements change by more than two times the root mean square difference (RMSD) of the repeat measurement. Peak systolic velocity and end diastolic velocity measurements at a Doppler angle of 60 degrees were repeated in 47 carotid examinations. Measurement difference between sonographers and between instruments was tabulated. Root mean square difference was 11 cm/s (RMS%D = 11%) for systolic and 7 cm/s (RMS%D = 21%) for diastolic velocity measurements (excluding one severe stenosis case). Results for differences between sonographers and between instruments were similar to the overall results. In serial arterial studies using this Doppler velocimetry method, a difference exceeding 23 cm/s (21%) systolic, or 14 cm/s (42%) diastolic velocity indicates a significant (2 x RMSD) hemodynamic change.