Chapter 10: Doppler Evaluation of the Pelvis Flashcards
When the sound wave encounters a distinct surface that is larger than the wavelength of the ultrasound beam
Speculate reflectors
Physiologic process involving the growth of new blood cells from preexisting vessels
Angiogenesis
Small vascular structures found along the periphery of the uterus
Arcuate vessels
Measurements used to compare the resistance of a medium to the propagation of flow
Impedances indices
A sonographic indicator of an organ to perfusion. Calculated from the peak systolic velocity and the end- diastolic velocity of blood flow.
Resistive index
Days 5 to 9 of the menstrual cycle
Early proliferative phase
Days 10 to 14 of the menstrual cycle
Late proliferative phase
Doppler measurement that uses peak systole minus peak diastole divided by the mean
Pulsatility index
Difference between peak systolic vale and end diastolic values of a vessel
S/D ratio
Days 15-28 of the menstrual cycles
Secretory phase
Main vessel carrying oxygenated blood toward the uterus
Uterine artery
Abnormal connection between veins and arteries
Arteriovenous malformation
Anatomical parts added, attached, or adjunct to another or others
Adnexa
Blood vessels that supply oxygenated blood to and drain deoxygenated blood away from the ovaries
Ovarian vessels
Malignant tumors, benign tumors, and inflammatory conditions are not related to:
a. angiogenesis
b. normal physiologic blood flow
c. abnormal blood flow
d. hypoxia
d
Select the true statement regarding ACR practice guidelines for an ultrasound examination of the female pelvis:
a. use the lowest possible sonographic exposure settings to gain the necessary diagnostic information
b. identify all the relevant structures through transabdominal or transvaginal imaging, knowing that in few cases both will be needed
c. High-quality patient care requires no demographic documentation
d. conduct the sonographic examination of the female pelvis with a real-time scanner without transducer frequency adjustment
a
Choose the most appropriate transducer frequency for a transabdominal pelvic sonogram when more depth penetration is needed.
a. 2.5MHz
b. 5.0MHz
c. 7.5 MHz
d. 12 MHz
a
A full urinary bladder enhances uterine visualization, but frequently causes a suboptimal ______ Doppler exam owing to the angle of incidence.
uterine artery
If a cystic mass is suspected during a full bladder pelvic ultrasound examination, the patient should:
void the urinary bladder and further investigate the pelvis
Which position provides the best visualization of free fluid in the pouch of Douglas during an endovaginal ultrasound exam?
lithotomy with a slight reverse Trendelenburg
Quantitative measurements of Doppler studies include:
measurements of absolute blood velocities, assessment of vascular impedances, and quantifying flow disturbances
With constant perfusion pressure, the flow _____ as the impedance to flow _____.
increases, decreases
Resistive Index (RI) calculates:
the mean systolic and diastolic ratio
Suspicion for vascular occlusion occurs when a:
high resistance pattern is detected where low resistance is normally seen
A correct angle of _____ is required when analyzing vascular flow to determine its velocity by a Doppler shift.
less than 60 degrees
Normal arterial flow is seen as:
alternating quick uptake systolic peak followed by a lower diastolic flow
What is laminar flow?
blood velocity traveling highest in the mid vessel
Name the vessel (appearing as a tubular structure) often seen sonographically in the outer uterine myometrium.
arcuate artery
The functional layer of the endometrium is supplied blood by the:
spiral artery
An arteriovenous malformation (AVM):
a. is commonly seen in the cervix
b. mostly involves the uterine endometrium
c. is typically acquired through surgery or trauma
d. is hyperechoic and well circumscribed
c
Choose a statement that is not related to pelvic congestion.
a. frequently diagnosed in nulliparous women
b. vulvar, perineal, and lower extremity varices
c. chronic dull pelvic ache
d. Worsens with prolonged standing or walking
a
The best description of classic ovarian torsion is:
an enlarged, edematous ovary with multiple small peripheral follicles and little or no vascular flow
Complex cysts of the pelvis are:
a. malignant if seen with papillary cystic projections and free fluid
b. benign if void of a thick septa and thick walls
c. difficult to discriminate because benign and malignant characteristics can be similar
d. diagnosed only with Doppler evaluation
c
Which statement is correct?
a. Low resistance flow has a low end-diastolic and peak systolic velocity
b. High resistance flow has a low end-diastolic value with a high peak systolic value
c. High resistance flow has a high end-diastolic and low peak systolic velocity
d. Arteries always demonstrate high resistance flow whereas veins always demonstrate low resistance flow
d
_____ ultrasound is a vital component in the evaluation of pelvic pathology and physiology.
Doppler
Following a transvaginal examination, clean the transducer with a(n) ______ solution.
antimicrobial
Two ultrasound examinations that complement each other are _____ and _____
endovaginal
transabominal
A sonographer must question every patient _____ allergies.
latex
The uterine artery tends to be ______ and travels in a spiral fashion on the lateral aspect of the uterus.
tortuous
The ovarian vein diameter in nulliparous women is ___ mm and can be up to ___ mm in women who have had children.
4
8
High and low _______ are the two types of arterial Doppler flow analysis.
resistance
The presence of blood flow in a select area or vessel, at a known depth, with a sample volume describes ____ Doppler.
pulsed
The acronym BART means:
blue away, red towards
The standard measurement used when displaying the spectral waveform is velocity, which is written as:
m/sec or cm/sec
Color Doppler, which is a color _____, is based on the amount of the frequency shift and the _____ they are moving in relation to the transducer.
overlay
direction
Power or energy Doppler displays movement, but without the attempt to obtain a _____ shift.
frequency
Doppler ultrasound has been utilized as a noninvasive technique to assess blood flow _____.
impedance
The ovarian artery anastamoses with the _____ artery at the uterine cornua.
uterine
Mid-luteal phase uterine arterial flow mean values in premenopausal patients are similiar to that of ______ patients.
postmenopausal
The ureters and _____ arteries follow an inferior track over the ____ muscle.
ovarian
psoas
The ovarian veins travel differently in the left pelvis than the right pelvis. The left ovarian vein courses _______ and drains into the left ____ vein. The _____ receives the right ovarian blood flow.
superiorly
renal
IVC
Although the gold standard for diagnosing pelvic congestion was traditionally _____, sonographic assessment with a ______ maneuver technique gave ultrasound an advantage with diagnosing pelvic congestion.
venography
valsalva
During pregnancy, veins _____ to accomadate increased blood ____.
dilate
flow
The early proliferative phase is day ____ of the menstrual cycle.
1
