Question

While performing a Doppler evaluation of the abdominal vessels, you detect a stenosis in the right renal artery. Which of the following is not a sign of stenosis with spectral analysis?

A) Spectral broadening distal to the stenosis

B) Increased peak systolic velocity at the stenosis

C) Increased peak diastolic velocity proximal to the stenosis

D) Increased pulsatility proximal to the stenosis

E) Dampening of the waveform distal to the stenosis

Answer 1

Increased peak diastolic velocity proximal to the stenosis is not a typical sign of stenosis in spectral Doppler analysis; this finding may indicate other vascular conditions.

Step-by-step explanation:

When performing a Doppler evaluation to detect stenosis in an artery, such as the right renal artery, there are specific signs that indicate its presence. According to spectral analysis, spectral broadening is seen distal to the stenosis due to turbulent flow (A), an increased peak systolic velocity occurs at the site of the stenosis (B), and there might be dampening of the waveform distal to the stenosis due to a drop in velocity after the narrowed segment (E). However, an increased peak diastolic velocity proximal to the stenosis (C) is typically not a sign of stenosis; instead, it could indicate a low-resistance vascular bed distal to the measurement site, like in hyperemia or arteriovenous shunting. Increased pulsatility proximal to the stenosis (D) is indeed a sign of arterial stenosis and indicates increased resistance against blood flow due to the narrowing of the vessel.