Chapter 13 Duplex/ Flow Imaging Abdomen Flashcards
What is the purpose of evaluating the aorto-iliac vessels
Evaluate vessels for stenosis, status of bypass grafts and aneurysmal disease
The renal arteries to evaluated to document a ________% diameter reduction
> 60%
Why are the kidneys evaluated
To help in the evaluation of nephrosclerotic disease
Why are the mesenteric arteries evaluated
To document significant stenosis or evaluation of mesenteric bowel ischemia
Why is the liver evaluated
For suspected portal hypertension and pre/post liver transplants
In the aorto iliac arteries a dilation of 3 cm or an increase in diameter of 50% or greater than the original artery is a sign of an
Aneurysm
The majority of AAAs are _______ and ________
Atherosclerotic and infrarenal
What is the most frequent complication of the aorto iliac arteries
Rupture of the aortic aneurysm
Many patients who have hypertension have ___________ hypertension
Renovascular
Renovascular hypertension is usually caused from _________ or _______
Renal artery stenosis, occlusion
The renal arteries and kidney arteries are
A) high resistant
B) low resistant
B) low resistant
Name 3 arteries that are low resistant
1) celiac
2) hepatic
3) splenic
The aorta is usually
A) high resistant
B) low resistant
A) high resistant
Name 2 arteries that are high resistive
Fasting SMA and IMA
How do you calculate the renal to aortic ratio (RAR)
Highest renal artery PSV/ aorta PSV
What is a normal RAR
< 3.5
What is an abnormal RAR
> 3.5
An RAR of > 3.5 suggest
> 60% of diameter reduction
What are the 2 reasons one can’t use the RAR
1) if AAA is detected
2) if aortic PSV > 90 cm/s or < 40 cm/s
What is the normal length of the adult kidneys
10-12 cm
How do you calculate the end diastolic ratio (EDR)
End diastolic V/ PSV
What is a normal EDR value
> 0.2
What does EDR stand for
End diastolic ratio
What is an abnormal EDR
< 0.2
How do you calculate the RI
PSV-EDV/ PSV
What is a normal RI
<0.75
What is an abnormal RI
> 0.75
Proximal high grade stenosis/ occlusion of renal artery may result in _________ _______ Doppler signals distally
Dampened, weak
Patients presenting with a history of dull, achy or crampy abdominal areas sun 15-30 minutes after meals are suspected for
Mesenteric ischemia
The pain for mesenteric ischemia is also known as
Mesenteric angina
What is the PSV, EDV and flow reversal of the SMA of a pre-prandial fasting patient
PSV- high
EDV- low
Flow reversal- yes
What is the PSV,EDV, and flow reversal of the celiac in a pre-prandial fasting patient
PSV- high
EDV- high
Flow reversal- no
What is the PSV, EDV, and loss of flow reversal in the SMA of a post-prandial patient
PSV- marked increase
EDV- marked increase
Loss of flow reversal- yes
What is the PSV, EDV, and loss of flow reversal in the celiac of a post- prandial patient
PSV- no change
EDV- no change
Loss of flow reversal- N/A
What is the normal PSV of the SMA
110-177 cm/sec
What is the normal PSV of the celiac
50-160 cm/sec
If there is a stenosis in the SMA the PSV is _______ and predicts a ______% diameter reduction
> 275 and 70%
If there is a stenosis in the celiac the PSV is _______ and predicts a ________ diameter reduction
> 200 cm/sec and 70%
In most cases _____ of _____ mesenteric vessels have to be abnormal to be consistent with chronic mesenteric ischemia
2 of 3
Extrinsic compression of the celiac artery origin by the
Median arcuate ligament
What transducer frequency would you use for an organ transplant allograft
5 or 3 MHz
Pre and post operative evaluation of a liver transplant include documenting patency of what 4 things
1) portal vein
2) hepatic veins
3) IVC
4) hepatic artery
What transducer frequency should be used for a renal transplant
5 MHz
A transplanted renal artery is anastomosed to what
EIA or IIA
A transplanted RV is anastomosed to the
EIV
What are the 2 signs of B-mode renal transplant rejection
1) increased renal transplant size
2) increased cortical echogenicity
What is the most reliable method for renal transplant rejection diagnosis
Biopsy
