Determination of the most appropriate velocity threshold for applying hemispheric flow convergence equations to calculate flow rate: selected according to the transorifice pressure gradient. Digital computer analysis of the Doppler color flow convergence region.

An understanding of the basic concepts of the physics of blood flow is of vital importance to the cardiologist as he or she attempts to utilize new blood flow imaging modalities, such as Doppler ultrasound and nuclear magnetic resonance imaging. Concepts such as the Bernoulli equation and its limitations, the continuity equation and volume flow calculations and the theory of free and confined jets have applications in cardiac blood flow-related problems. For example, mitral regurgitant flow may be treated with the free jet theory. Aortic stenosis results in confined jet flow. It is important that the cardiologist understand the basic principles behind these hydrodynamic concepts so that he or she can use them in appropriate applications. The limitations of the simplification of complex hydrodynamic relations that are used clinically need to be clearly understood so that these simplified principles are not used improperly or used to draw oversimplified conclusions.

Major clinical uses of the new Doppler color flow mapping technologies involve the imaging of disturbed flow through cardiac defects or valves. Nevertheless, there is little general understanding of the determinants of flow and of how flow is imaged by these new systems. This review will attempt to relate the hydrodynamics through a simplified stenotic or regurgitant orifice with the physics and sampling theories relevant to the functioning of Doppler color flow mapping systems. The goal will be to characterize the velocity resolution, spatial resolution, sensitivity and performance of these systems so that clinicians can understand why flow looks the way it does on Doppler color studies and which aspects of flow mapping can be expected to become more quantifiable than they are at present.