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SUMARYA noninvasive method for real time blood-flow imaging using ultrasound has long been required in the fields of cardiology, and cardiovascular surgery. Recently, we developed a method of twodimensional Doppler echocardiography (hereafter abbreviated as "2 -D Doppler") for clinical use which allows us to obtain noninvasively, intracardiac blood-flow images in real time. The main purpose of this paper is to describe the newly developed blood-flow imaging system "2-D Doppler" and to demonstrate its clinical usefulness in acquired valvular diseases, particularly in the evaluation of valvular regurgitation.The device, in principle, combines a conventional pulsed-Doppler system and a newly developed auto-correlator, in which bloodflow images within a given cross section of a beating heart are noninvasively displayed in real time, simultaneously with conventional two-dimensional echocardiograms. The system can provide three kinds of information, direction, velocity and turbulence of blood flow.The 2-D Doppler examinations were carried out on 72 patients with acquired valvular diseases whose diagnoses were confirmed by From *the First

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