Duplex Scanning and Color Flow Imaging of the Abdominal Vessels Flashcards
majority of AAAs are ___ and ___
atherosclerotic and infrarenal
what is renovascular hypertension?
secondary form of high BP often caused by renal artery stenosis or occlusion
PSV of the aorta is obtained just distal to the ___
SMA
when evaluating the kidneys, obtain PSV and EDV from (3)
renal artery - prox, mid, distal
segmental arteries
interlobar arteries - upper and lower poles
renal-to-aortic ratio (RAR) =
normal
abnormal
renal-to-aortic ratio (RAR) = renal artery PSV / aortic PSV
normal < 3.5
abnormal ≥ 3.5
RAR might not be accurate when (2)
an AAA is present
PSVs of the aorta are < 40cm/sec or > 90cm/sec
end-diastolic ratio (EDR) =
normal
abnormal
end-diastolic ratio (EDR) = EDV /PSV
normal ≥ 0.2
abnormal < 0.2
EDR helps determine if flow resistance has ___
increased (abnormal)
Pourcelot’s ratio/resistivity index (RI) =
normal
abnormal
Pourcelot’s ratio/resistivity index (RI) = (PSV - EDV) / PSV
normal < 0.7
abnormal ≥ 0.7
renal resistive-index valve (RRIV) =
improvement
worsening
renal resistive-index valve (RRIV) = ( 1 - EDV ) / PSV
improvement < 0.75
worsening ≥ 0.75
renal resistive-index valve (RRIV)
PSV and EDV are from the ___ arteries
segmental arteries
renal resistive-index valve (RRIV)
prospectively identify patients whose renal function or BP will improve after correction of ___
renal artery stenosis
what is acceleration time (AT)?
time interval form the onset of systole to the initial peak
what is acceleration index (AI)?
slope of the Doppler velocity waveform
acceleration index (AI) =
acceleration index (AI) = (onset of systole - peak systole) / AT
≥ 60% diameter reduction
AT ___
AI ___
AT ≥ 100 cm/sec
AI ≥ 291 cm/sec
what is mesenteric ischemia?
abdominal pain 15-30mins after meals
mesenteric ischemia is difficult to diagnose so an ___ is essential
arteriogram
mesenteric ischemia
obtain PSV and EDV from (4) while patient is fasting
celiac trunk
SMA
IMA
aorta
mesenteric ischemia
give patient a high-calorie liquid meal and wait ___ mins before obtaining PSV and EDV again
20-30 mins
pre-prandial SMA
PSV
EDV
flow reversal
pre-prandial SMA
PSV - high
EDV - low
flow reversal - yes
post-prandial SMA
PSV
EDV
loss of flow reversal
post-prandial SMA
PSV - marked increase
EDV - marked increase
loss of flow reversal - yes
SMA velocity
normal PSV:
stenosis:
SMA velocity
normal PSV: 110-117 cm/sec)
stenosis ≥ 175 cm/sec
pre-prandial celiac artery
PSV
EDV
flow reversal
pre-prandial celiac artery
PSV - high
EDV - high
flow reversal - no
post-prandial celiac artery
PSV
EDV
loss of flow reversal
post-prandial celiac artery
PSV - no change
EDV - no change
loss of flow reversal - N/A
celiac artery velocity
normal PSV:
stenosis:
celiac artery velocity
normal PSV: 50-160 cm/sec
stenosis: ≥ 200 cm/sec
what is celiac band syndrome?
extrinsic compression of the celiac artery by the median arcuate ligament of the diaphragm
celiac band syndrome
high-velocity signals of stenosis improve with ___ and return with ___
improve with deep inspiration
return with expiration
___ can provide collateralization in response to an occlusion of the SMA
IMA can provide
arc of Riolan
marginal artery of Drummond
liver transplant pre-operative duplex
evaluate candidates for transplant by checking patency of (5) and determine status of biliary tree
portal vein
splenic vein
SMV
hepatic artery/veins
IVC
liver transplant post-operative duplex
complications (4)
allograft rejection
pseudoaneurysm
hepatic infarction
thrombosis of PV, IVC, and/or HA
most renal transplants will be found in the ___
right iliac fossa
3 types of anastomosis for renal transplant
RA end-to-side with EIA
RA end-to-side with EIV
RA end-to-end with IIA
renal transplant post-operative follow up includes Doppler spectral analysis of the (5)
aorta
EIA or IIA
EIV
donor RA/RV
allograft vessels
renal transplant B-mode signs of rejection (3)
increased renal transplant size
increased cortical echogenicity
hypoechoic regions in the parenchyma
___ is the most reliable method for transplant rejection diagnosis
biopsy
