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Controversies in the Interpretation of Doppler Waveform

Waveform analysis is inherent to nearly every procedure performed in the vascular laboratory, yet waveform terminology and definitions have not been standardized. A review of waveform literature notes that three terms have been used to classify Doppler waveforms in the peripheral arterial circulation—triphasic, biphasic, and monophasic. These terms, however, are briefly detailed, often contradictory, are substituted by alternative terminology and also used for classifying waveforms generated by plethysmographic devices. Because sonographers are the primary party in waveform classification, failing to address this issue will be most keenly felt in the future. In the advent of vascular ultrasound sonographers received an average of three years on-the-job training; today career option is no longer available and formal ultrasound education is mandatory. Furthermore, physicians and ancillary medical personnel are integrating ultrasound into their practices. A lack of waveform standards has the potential to stimulate inappropriate testing and is hindering the advancement of the vascular ultrasound profession.