Regurgitant blood flow can be:

• Low or high velocity
• Laminar or turbulent

You may or may not see aliasing in regurgitant flow jet. Any view that shows both the valve and the chamber proximal to it can help you detect regurgitation. Although CFI can help you detect valvular regurgitation, its accuracy in estimating the severity of regurgitation is still an area of discussion. While many sources apply the PW Doppler grading system (judging the extension of the regurgitant jet into the receiving chamber) to CFI, they caution that many morphological, physiological, and technical factors influence the size of the jet seen.

Actual regurgitant volume may be larger or smaller than it appears on the CFI image due to:

• Cardiac output
• The regurgitant jet driving pressure
• The size of the regurgitant orifice
• Gain settings

To obtain the best estimate of size, it is critical to image a regurgitant jet in several different views. The width and length of a jet may vary considerably from one view to the next as it moves in and out of the imaging planes. In addition, color M-mode can help evaluate a regurgitant flow jet by providing precise timing information.

Regurgitant Blood Flow: Mitral Regurgitation (MR)

Mitral regurgitation (MR) is best viewed from the parasternal long-axis and apical views. MR appears in systole, as blood flow entering the left atrium (LA) through the MV.

This magnified parasternal long-axis view shows MR in the LA in systole. Since the MR moves away from the transducer, it is primarily colored blue. Yellows represent the aliased flow velocities in the utilized enhanced map. A mosaic of blue and yellow indicates the turbulence of the blood flow.

This apical four-chamber view also shows systolic MR. In this view the MR jet has a mosaic appearance. Since a variance map is used, the yellows indicate turbulent flow. The red in the LA represents normal systolic filling.

Click below to view a real-time image of MR. module230_MRANDA~1.AVI

Mitral%20Regurgitation.avi