Radiology · Vascular and Cardiac Imaging (CT Angiography, Coronary, Aortic, Doppler)

On Doppler ultrasound of the carotid artery, a post-stenotic flow pattern distal to a critical stenosis shows 'tardus-parvus' waveform. This waveform is characterised by:

  • A Low peak systolic velocity with a delayed, rounded upstroke (prolonged systolic acceleration time) ✓
  • B High peak systolic velocity with a sharp upstroke
  • C Reversed diastolic flow indicating aortic regurgitation
  • D Monophasic flow with absent diastolic component
Correct answer: A. Low peak systolic velocity with a delayed, rounded upstroke (prolonged systolic acceleration time)

Explanation

Tardus-parvus ('slow-small') waveform describes the downstream pattern seen distal to a significant stenosis. 'Tardus' refers to delayed/prolonged systolic upstroke (prolonged systolic acceleration time >70–100 ms), and 'parvus' refers to diminished peak systolic velocity. These features indicate damping of the pulsatile flow by the stenosis. It is characteristically seen in renal artery stenosis (on renal Doppler) and carotid/peripheral arterial stenosis. It differs from reversed diastolic flow (seen in aortic regurgitation) or absent diastole (high-resistance states).

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

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