Doc #: 60-00118 Rev. A
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Bubble Study
1. The Bubble Study exam is intended to be used to detect arterial micro bubbles from an
intravenous injection. Detection of bubbles in cerebral arteries may indicate a right to left
vascular shunt. This exam is frequently used to detect a Patent Foramen Ovale.
2. This exam can be performed either unilaterally or bilaterally.
3.
After the vessel or vessels are located, select “Start Exam” to begin the recording.
4. With the TCD recording running, the intravenous micro bubble injection can be given.
Follow standard “At Rest” and “With Valsalva Strain” injection/Valsalva timing protocols.
5. Continue the recording for at least one minute after the injection. Snapshots of
representative bubble activity can be taken during the exam or after the exam in Exam
Review.
6.
Click “Exit Exam” to stop the recording and advance to the Exam Review screen.
7. Replay the recording to visualize any bubbles.
8. Pause the recording and take a snapshot of segment with the maximum number of
bubbles for the “At Rest” and “With Valsalva” segments of the study. If only one injection
is given, the software will assume it was with Valsalva.
9. Use the back icon to return to the Exam Review: Snapshots page to select and identify
the snapshot(s) to be included in the report.
10. Enter the actual or estimated number of bubbles for each snapshot.
11. The software will convert the bubble count to a Spencer Logarithmic Scale shunt grade.
Bubble Study Report