Color flow imaging and conventional two- dimensional pulsed Doppler echocardiography: selected observations and experience

In 1978, Brandestini and co-workers at the University of Washington produced a channel digital multigate Doppler instrument [1, 2] which, for the first time in clinical ultrasound, allowed imaging of cardiac structure and blood flow in real time. Clinical trials suggested utility in evaluation of a variety of defects, including atrial and ventricular septal defects, patent ductus arteriosus, and atrioventricular valve regurgitation [3–5]. That multigate Doppler device was introduced into a Doppler field at a time when the credibility and acceptance of Doppler techniques had not yet occurred in many areas. While the color Doppler format was greeted with interest, it was considered by many to be just an interesting ‘gimick’. American journals felt that the instrument, and reports of its utility to be too preliminary to deserve priority sufficient to publish. Reports of the initial applications thus appeared in the more open minded European literature. The Brandestini instrument remained a uniquely curious unit, and did not progress toward commercial availability. At about the same time, our Japanese colleagues were engaged in work toward production of a commercially available real time flow imaging system. Because of barriers imposed by language and communication, neither center was fully aware of each other’s activity. But, with the introduction of the Japanese system, at a later time when Doppler techniques had come to be accepted, an enthusiastic resurgence in interest in color flow imaging was noted.[6].