Duplex/color flow imaging (abdomen)

Question 1

A dilation > 3cm or an increase in diameter of 50% greater than original artery.

Answer 1

Aorto-iliac arteries aneurysm

Question 1

Evaluate vessels for stenosis, status of bypass grafts, aneurysmal disease

Answer 1

Aorto-iliac vessels

Question 2

Majority of abdominal aortic aneurysms (AAA) are

Answer 2

atherosclerotic and intrarenal

Question 3

Rupture of the aortic aneurysm; embolization of the peripheral aneurysms (could cause blue toe) Trash foot

Answer 3

Most frequent complication with aneurysm

Question 4

An enzyme that converts angiotensinogen to angiotensin

(related to renovascular hypertension)

Answer 4

Renin

Question 5

Many of these patients with present with hypertension (controlled or not controlled)

Answer 5

Renal artery studies

Question 6

Renal arteries and kidney arteries are normally more ____ resistant

Answer 6

Low (above baseline diastole)

Question 7

The aorta is usually _______ resistant

Answer 7

Higher

Question 8

If a AAA is detected you cannot use

Answer 8

Renal to aortic ratio (RAR)

Question 9

Highest renal artery divided by Aorta PSV

Answer 9

Renal to aortic ratio (RAR)

Question 10

If aortic PSV is > 90 cm/s or < 40 cm/s you cannot use

Answer 10

Renal to aortic ratio (RAR)

Question 11

Abnormal (RAR)

Answer 11

> 3.5 (suggests > 60% diameter reduction)

Question 12

Normal (RAR)

Answer 12

< 3.5

Question 13

> 180 - 200 cm/s that is followed by post - stenotic turbulence

Answer 13

Too fast!

Question 14

Normal pole length of a kidney is

Answer 14

10-12 cm.

Question 15

End diastolic ratio
Parenchymal resistance ratio (PR) normal is
End Diastolic V divided by
PSV

Answer 15

> 0.2

Question 16

End diastolic ratio
Parenchymal resistance ratio (PR) abnormal is

Answer 16

< .2

Question 17

Resistivity Index
PSV- EDV divided by
PSV
Normal

Answer 17

< .8 (low resistance)

Question 18

Resistivity Index
PSV- EDV divided by
PSV
abnormal

Answer 18

> .8

Question 19

Patients presenting with a history of dull, achy or crampy abdominal pian 15-30 minutes after meals are suspect for

Answer 19

Mesenteric ischemia

Question 20

Chronic and acute mesenteric ischemia is difficult to diagnose and require a

Answer 20

Arteriogram

Question 21

Obtain the PSV and EDV of the following: (longitudinal approach)

Celiac artery (may use TX approach)
Proximal, mid, distal SMA
IMA
Aorta (check for abnormalities)

Answer 21

Technique

Question 22

High resistance flow pre-prandial
Converts to lower resistance flow post-prandial
Normal velocities range from 110-177 cm/s
Abnormal velocities PSV > 275 cm/s predicts > 70% diameter reduction

Answer 22

SMA

Question 23

Low resistance flow pre- prandial (always)
Remails low resistance post - prandial (unaffected by eating)
Normal velocities range from 50-160 cm/s
Abnormal velocities PSV > 200 cm/s predicts > 70% diameter reduction

Answer 23

Celiac Artery

Question 24

Pre - prandial high resistant waveform remains high resistant post - prandial which suggests distal mesenteric disease

Answer 24

Abnormal SMA

Question 25

Marginal Artery of the colon (AKA marginal A. of Drummond)

Arc of Riolan

Answer 25

IMA two possible connections

Question 26

Extrinsic compression of celiac artery origin by the median arcuate ligament of the diaphragm

Answer 26

Celiac band syndrome

Question 27

Documenting patency of portal vein, hepatic veins, IVC and hepatic artery

Answer 27

Pre and post operative eval liver transplant

Question 28

Example of grayscale signs of rejection for renal transplant

Answer 28

Increased renal transplant size

Question 29

Transplanted RA anastomosed to EIA or IIA; transplanted RV anastomosed to EIV

Answer 29

Renal transplant

Question 30

Increased arterial resistance

Answer 30

Acute rejection (renal transplant)

Question 31

What is consider the most reliable method for rejection diagnosis for kidney transplant patients

Answer 31

Biopsy