Chapter 13: Abdominal Duplex Flashcards
Renal artery stenosis patients usually present with
uncontrolled/controlled hypertension
many patients who have hypertension have
renovascular hypertension due to renal artery stenosis
renal artery stenosis is usually caused by
atherosclerosis
fibromuscular dysplasia
occlusion
renin
enzyme that converts angiotensinogen to angiotensin
renal artery stenosis study native kidneys obtain this information
celiac and sma velocities
PSV of aorta near SMA
kidney size
PSV and EDV of prx, mid, dst renal arts, upper lower pole segmental arteries
renal arteries are usually
low resistant
the aorta is usually
higher resistant
RAR (renal to aorta ratio) equation
highest renal artery PSV / Aorta PSV
Normal RAR
<3.5
Abnormal RAR
> or = to 3.5
suggests 60% diameter reduction
You cannot use RAR if:
AAA present
Aorta PSV >90cm/sec or <40cm/s
look for renal artery PSV >/= 180-200 cm/sec
End diastolic Ratio (EDR) Parencyma Resistance Ratio (PR) equation
end diastolic velocity / PSV
Parencyma Resistance Ratio (PR) equation
end diastolic velocity / PSV
Normal PR kidneys
> .2
Abnormal PR kidneys
<.2
Resistivity index (RI) equation
PSV - EDV / PSV
Normal RI kidneys
< .8
Abnormal RI kidneys
> / = .8
acceleration time of what is considered abnormal
> 100msec
Proximal stenosis / occlusion of renal artery may result in
dampened, weak doppler signals distally
tardus parvus
Celiac band syndrome is
compression of celiac artery origin by median arcuate ligament of diaphragm
Mesenteric ischemia protocal
on fasting patient PSV and EDV of celiac artery prox mid dist SMA IMA Aorta
Food challenge test
Mesenteric Ischemia study done and then feed pt high caloric liquid (ensure)
repeat exam 20-30 min or sooner if symptomatic
obtain PSV and EDV of SMA post prandial
what to document after food challenge test
amount of liquid ingested
onset type and duration of symptoms
time began the post prandial study
Fasting SMA
High PSV
Low EDV
Flow reversal
Post Prandial SMA
PSV increased
EDV increased
loss of flow reversal
Celiac Artery fasting
High PSV
High EDV
no flow reversal
Post prandial celiac artery
No change in PSV or EDV
no flow reversal
SMA normal velocity
110-177cm/sec
Stenosis of SMA
PSV > / = to 275cm/sec means 70% diameter reduction
Normal Celiac artery velocity
50-160cm/sec
Stenosis of Celiac artery velocity
PSV >/= to 200cm/sec means 70% diameter reduction
if IMA is easily observed what should be considered
SMA occlusion
how many vessels have to be abnormal for mesenteric ischemia to be considered
2 to 3 vessels
Celiac band syndrome is
compression of celiac artery origin by median arcuate ligament of diaphragm
What do you see in celiac band syndrome
stenosis occurs during expiration
deep inspiration improves high velocity signals
renal transplant anastomosis to
EIA or IIA
vein transplanted to EIV
Signs of renal transplant rejection
increased size
increased cortical echogenicity
increased arterial resistance
