Cerebrovascular Ultrasound How to Do It Well 

Excellent presentation thank you so much for taking the time and putting th

Great presentation, great teaching

This has been a subject I had to debate and disagree on, but I recall reading an article about the whole idea behind keeping the angel correct to 60 degrees as an old school and outdated approach. So back then, there's an argument that if we used a correction angle that is less than 60 degree, we introduce false velocities. But that's not true because it should be automatically corrected from the machine's mathematical formula. If we think back to trigonometry and the simplified doppler shift equation where, v = v(toward)/cos (theta), we need the denominator to be anything but zero. The only way we get zero is when we take cosine of 90 or 270 degrees. Therefore, the further we are away from those degrees, the less error we introduce into our equation. Ideally, we want the denominator to be 1 or as close to one as possible. The only way to get 1 is to take the cosine of 0 or 180 degrees. In ultrasound, this is when our beam is perfectly parallel with the direction of blood flow. But that's almost never the case. Therefore, we use angle correction to adjust for the differences. So with that being said, wouldn't it make sense to rock your probe and get the vessel to slant as much as you can so we can use an angle correction of 60 or BELOW? Ideally, I think the lesser the angle, the better. So an angle correction of 45 degrees for example, is more accurate than 60, and 20 degree is better than 45, and 0 degree is the best. I know it's been a long winded comment. But there's a point to all this. Whenever I look at a tech's work and see that he ONLY scans with 60 degrees, I am thinking that he does not understand trigonometry and been taught old school method, which was never challenged and looked at in depth. I have also tested how angle correct affect velocities by adjusting the angle from 0 to as close to 90 as I possibly can. What happened was that I can only introduce dampened, or lower velocity error by using an angle over 60 degree. But the opposite was not true, meaning I could not artificially elevate the vessel's velocity by putting it close to zero. For those who are interested in reading the literature on this subject, go here: www.ncbi.nlm.nih.gov/pmc/articles/PMC5024856/

great lecture! thanks from russian sonographers!

Excellent Lecture.

Informative. Thank you

Excellent and brilliant presentation.

Thank youuuu, very useful

Excellent and brilliant presentation. Thank you very much.

Thanks a ton, its very helpful.

that was amazing! thanking for sharing this information

thank you great lecture

awesome ,thank you

Thank you

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Purely theoretical lecture, no advice about tips to perform the scan. One can read the theory stuff with pre saved images from books / articles.