Duplex/color flow imaging ABD

Question 1

Arteries imaged?

Answer 1

Celiac, SMA, renal arteries, aorta, common iliacs, externally iliacs (prox, mid, distal), and internal iliac artery

Question 2

An aneurysm is classified when?

Answer 2

Dilation > 3 cm or 50 % increase in diameter of original artery

Question 3

The majority of AAA are?

Answer 3

atherosclerotic and infrarenal

Question 4

Most frequent complications of an AAA?

Answer 4

rupture or embolization of the peripheral aneurysms

Question 5

Many patients who have hypertension have?

Answer 5

renovascular hypertension

Question 6

Renal artery stenosis can be secondary to what?

Answer 6

atherosclerosis or fibromuscular dysplasia

Question 7

Renal artery protocal:

Answer 7

a) celiac and SMA velocity data
b) aorta PSV near SMA level
c) evaluate kidneys
d) PSV and EDV of prox, mid, distal renal artery
e) PSV and EDV of upper and lower pole of kidney in seg arteries
f) observe for secondary or accessory renal arteries

Question 8

Renal arteries, kidney arteries, celiac, hepatic, and splenic arteries are all what resistance?

Answer 8

low

Question 9

The aorta and fasting SMA and IMA are what resistance?

Answer 9

higher

Question 10

Renal to aortic ratio

Answer 10

highest renal artery PSV/ AO PSV

Question 11

Normal RAR:

Answer 11

less than 3.5

Question 12

Abnormal RAR:

Answer 12

> 3.5 suggests > 60 % diameter reduction

Question 13

When can an RAR not be used?

Answer 13

If AAA detected

If aortic PSV > 90cm/s or

Question 14

End Diastolic Ratio (EDR) or the parenchymal resistance ratio for kidney:

Answer 14

EDV/PSV

normal: > 0.2
abnormal: less than 0.2

Question 15

Resistivity index for kidney:

Answer 15

PSV-EDV/PSV

normal= 0.75

Question 16

Abnormal calculations indicate an increase in distal resistance:

Answer 16

nephrosclerotic disease

Question 17

With a PSV of 45 cm/s and an EDV of 5 cm/s, what is the EDR and the RI?

Answer 17

EDR= 0.1
RI= 0.88

Question 18

What is tardus parvus?

Answer 18

Dampened, weak doppler signals with low resistance quality

Question 19

Patients with a history of dull, achy or crampy abdominal pain 15-30 minutes after eating?

Answer 19

mesenteric ischemia

Question 20

mesenteric ischemia (angina) may be due to a stenosis or occlusion of?

Answer 20

SMA, celiac, or IMA

Question 21

Protocol for mesenteric arteries?

Answer 21

Fasting patient
PSV and EDV of celiac, SMA (p, m, d), IMA, and aorta
After eating (post-prandially) PSV and EDV of the SMA are obtained

Question 22

For the food challenge test, have patient drink high caloric liquid (Ensure) and repeat the exam within how much time?

Answer 22

20-30 minutes

hyperemic response begins after about 10 min, max response time about 30 min

Question 23

What is not influenced by the post-prandinal state?

Answer 23

Liver and spleen have fixed metabolic requirements

Celiac artery

Question 24

If IMA is easily observed, often suggests?

Answer 24

SMA occlusion

Question 25

In most cases how many mesenteric vessels have to be abnormal to be consistant with chronic mesenteric ischemia?

Answer 25

2 of 3

Question 26

Extrinsic compression of celiac artery origin by what is frequently seen?

Answer 26

median arcuate ligament of the diaphragm

Question 27

Pre and post operative evaluation of liver transplant includes documenting patency of?

Answer 27

portal vein, hepatic vein, IVC, and hepatic artery

Question 28

post-op liver transplant complications can include thrombosis of vessels such as?

Answer 28

portal vein, IVC, and/or hepatic artery leading to hepatic infarction

Question 29

Acute rejection will cause liver dysfunction and many suggest rejection is a?

Answer 29

cellular process

Question 30

Transplanted RA anastomosed to what arteries?

Transplanted RV to what vein?

Answer 30

RA: external iliac artery or internal
RV: external iliac vein

Question 31

post-op renal artery transplant includes?

Answer 31

renal artery doppler evaluation and kidney examination checking for hematoma and parenchymal echogenicity

Question 32

Signs of renal transplant rejection?

Answer 32

increased transplant size and increased cortical echogenicity
acute rejection often increases arterial resistance

Question 33

What method for rejection diagnosis for kidneys do many consider to be most reliable?

Answer 33

biopsy

others use the indicator of increased arterial resistance