Renal vascular Doppler imaging: clinical benefits of power mode

Power Doppler ultrasound (US) is a new technology that is superior to conventional color Doppler imaging in the detection of blood flow. Because of its greater sensitivity to flow and reduced angle dependence, power Doppler US demonstrates optimal color filling of renal pedicular vessels and allows improved evaluation of the renal parenchymal microvasculature. Power Doppler US was used as an adjunct to conventional color Doppler imaging in technically challenging cases and to improve evaluation of renal vascular disorders in a series of 916 patients. The primary clinical advantages of using power Doppler US compared with conventional color Doppler imaging include better morphologic appreciation of atherosclerotic changes in the renal artery wall, allowing improved diagnostic performance especially in hemodynamically nonsignificant plaques; ability to differentiate between subocclusive renal artery stenosis and occlusion; increased confidence in the diagnosis of renal vein thrombosis and in the assessment of caval tumor thrombus; and better appreciation of renal cortical perfusion defects. In addition, because of its greater sensitivity to perivascular artifact, power Doppler US has the potential to increase the detection rate for intrarenal arteriovenous fistulas.