The use of Doppler ultrasonography for the evaluation of cerebral artery flow patterns in infants with congenital heart disease.

With the use of a two-dimensional range-gated pulsed-Doppler ultrasound system, Doppler examinations of the aorta and cerebral arteries were performed in 20 normal newborn infants and in 54 infants with various forms of congenital heart disease (i.e. patent ductus arteriosus, coarctation of the aorta, critical aortic stenosis, pulmonary atresia, truncus arteriosus). In the cerebral artery Doppler recordings of the normal infants, there was antegrade flow throughout systole and diastole. In the cerebral artery Doppler recordings of the infants with cardiac disease, various abnormal flow signals (i.e. retrograde or absent diastolic flow signals, increased systolic and diastolic flow signals, etc.) were found. Furthermore, the changes in the cerebral artery Doppler recordings were concomitant with changes in the aortic Doppler flow signals and the arterial blood pressure. Representative examples of the normal and abnormal Doppler flow patterns that were observed in the aorta and cerebral arteries are presented, and the mechanisms that could lead to these flow patterns are discussed.