Reflux is the backward flow of fluids. For example, reflux of blood with proximal limb compression is an indicator of venous valvular incompetence.

See also Reflux Sonography.

Reflux sonography, as an alternative to micturating cystography (MCU), evaluates vesico-ureteral reflux (VUR), a common problem in children. Contrast enhanced pulse-inversion imaging shows best results. During the instillation of an ultrasound contrast agent into the bladder, (as for a conventional MCU) the lower ureters and renal pelves are scanned transabdominally as the bladder is filled to stimulate micturition.
Advantages for reflux sonography are a high sensitivity and the avoidance of X-rays. A disadvantage is the poorer depiction of the posterior urethra. However, for girls and for all follow-up studies, the ultrasound MCU has become standard in many pediatric ultrasound departments.

See also Urologic Ultrasound, Kidney Ultrasound, Ultrasound Safety, Ultrasound Imaging Modes.

Doppler fluximetry is a method to study the hemodynamic of fetus and placenta. Fluximetry is based on Doppler ultrasound. The resistance of blood flow in the vessels can be determined by quantitative or qualitative analyzing of sound waves depending on the pulsating blood flow.
Doppler fluximetry can be theoretically applied to vessels in every area of the body, but in practice insufficient size of some vessels is a limitation.

See also Doppler Effect.

Doppler ultrasound is a medical imaging technique for calculating the relative velocity between two points by measuring the frequency shift of a sound wave transmitted from one point to the other, based on the Doppler effect. Continuous or pulsed Doppler is frequently used to examine cardiovascular blood flow. The combination of routine 2D-mode and Doppler ultrasound allows a complete evaluation of the heart's anatomy and function (including the fetal heart). See also Doppler Fluximetry in Pregnancy.
Doppler ultrasound depends on the fact that if a moving object reflects the ultrasound waves, the echo frequencies are changed. A higher frequency is created if the object is moving toward the probe//transducer and a lower frequency if it is moving away from it. How much the frequency is changed depends upon how fast the object is moving. Doppler ultrasound shows the different rates of blood flow in different colors on a monitor in real time.
The major Doppler parameters are the peak systolic velocity and the end-diastolic velocity. The peak systolic velocity ratio compensates the variability between different patients and instrumentations.

Different Doppler and duplex techniques:

Fetal ultrasound is a safe and non-invasive imaging technique used to visualize and monitor the development of a fetus during pregnancy. It employs high-frequency sound waves to create detailed images of the baby, the placenta, and the uterus. Fetal ultrasound provides valuable information about the baby's growth, organ development, and overall well-being. It is commonly used to determine gestational age, assess fetal anatomy, detect abnormalities, and monitor fetal movements and heart rate. This essential tool enables healthcare professionals to ensure the optimal health of both the mother and the baby throughout the pregnancy.
The FDA (Food and Drug Administration) has established regulations governing ultrasound usage, including specific guidelines for fetal ultrasound examinations. These regulations permit an eight-fold increase in ultrasound intensity for fetal scans. They place considerably responsibility on the user to understand the output measurements, the mechanical index (MI), the thermal index (TI) and to use them in their scanning. The primary safety concern in prenatal diagnostic imaging is temperature rise. It is known that hyperthermia is teratogenic. The efforts of investigators have concentrated on defining the temperature increases and exposure times which may give rise to biological effects and on determining the ultrasound levels which might, in turn, lead to those temperature rises.
In fetal ultrasound, the highest temperature increase would be expected to occur at bone and the thermal index with bone at/near the focus (TIB) would give the 'worst case' conditions. The mechanical index and thermal index must be displayed if the ultrasound system is capable of exceeding an index of 1. The displayed indices are based on the manufacturer's experimental and modeled data. However, an independent study has demonstrated significant discrepancies over declared spatial peak time averaged intensity (I-SPTA) output of up to 400%.

See also ALARA Principle, Pregnancy Ultrasound and Doppler Fluximetry in Pregnancy.