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vascular sonography > IVC and Iliac Veins > Flashcards

IVC and Iliac Veins Flashcards

1
Q

Which of the following vessels extends as the external iliac vein?
a. common iliac vein
b. great saphenous vein
c. common femoral vein
d. inferior vena cava

A

C

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2
Q

In well-hydrated patients, what is the mean diameter of the inferior vena cava at the level of the renal veins?
a. 17 to 20mm
b. 10 to 15mm
c. 2 to 3cm
d. 3 to 5cm

A

A

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3
Q

Where does the left-sided IVC in a duplicate system typically terminate?
a. splenic vein
b. right renal vein
c. superior mesenteric vein
d. left renal vein

A

D - LRV

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4
Q

Upon ultrasound examination, the hepatic veins are noted to drain directly into the right atrium. What does this finding suggest?
a. normal findings in the hepatic veins
b. congenital absence of the inferior vena cava
c. membranous obstruction of the intrahepatic IVC
d. duplicate inferior vena cava syndrome

A

B

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5
Q

From a coronal plane in the left lateral decubitus position, what landmark can be used to identify the confluence of the common iliac veins to create the IVC?
a. superior pole of the right kidney
b. left lobe of the liver
c. inferior pole of the right kidney
d. inferior pole of the left kidney

A

C

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6
Q

What is the most common pathologic finding in the IVC and iliac veins?
a. tumor extension from renal cell carcinoma
b. thrombus extension from deep venous thrombosis in the legs
c. isolated thrombosis of the IVC
d. venous dissection through the iliac veins

A

B

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7
Q

Newly formed thrombus appears virtually _______________, whereas more advanced thrombus appears _______________.
a. hyperechoic, anechoic
b. hyperechoic, hypoechoic
c. hypoechoic, hypoechoic
d. anechoic, hyperechoic

A

D

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8
Q

From what do intraluminal tumors in the inferior vena cava most commonly arise?
a. pancreatic carcinoma
b. colon carcinoma
c. renal cell carcinoma
d. bladder carcinoma

A

C

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9
Q

In what ways can color-flow Doppler be particularly useful in identifying tissue bruits and pulsatile flow?
a. filter perforation
b. deep venous thrombosis
c. tumor extension
d. aortocaval fistula

A

D

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10
Q

During spectral Doppler analysis of the iliac system, continuous flow is noted in the common iliac veins bilaterally. What does this finding suggest?
a. obstruction in the common iliac veins
b. obstruction in the common femoral veins
c. obstruction in the inferior vena cava
d. normal findings in the common iliac veins

A

C - continuous flow will be seen DISTAL to an obstruction (common iliac veins are distal to the IVC)

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11
Q

What is the condition that occurs when the left common iliac vein is compressed between the overlying right common iliac artery and underlying vertebral body?
a. May–Thurner’s syndrome
b. Raynaud’s syndrome
c. arcuate ligament syndrome
d. Paget–Schroetter’s syndrome

A

A

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12
Q

What is filter placement in the inferior vena cava designed to prevent?
a. thrombus extension from the lower extremities
b. pulmonary embolus
c. thrombus extension from the intrahepatics
d. inferior vena cava tumor extension from the renal veins

A

B

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13
Q

Which of the following is a dependable marker for ultrasound identification of the level of the renal veins for IVC filter placement?
a. superior mesenteric artery
b. superior mesenteric vein
c. left renal vein
d. right renal artery

A

D - RRA

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14
Q

On sonographic evaluation, which of the following describes the appearance of an IVC filter?
a. hypoechoic, circular rings within the IVC lumen
b. hyperechoic, circular rings within the IVC lumen
c. echogenic lines that converge to a point d. hypoechoic lines that converge to a point

A

C

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15
Q

What veins are the pelvic viscera and musculature are drained by?

A

Internal iliac veins

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16
Q

What diameter is considered mega-cava?

A

> 28mm

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17
Q

An IVC filter is typically placed where in relation the the renal veins?

A

Distal

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18
Q

What type of waveform is present in the proximal IVC vs distal IVC?

A

Proximal - pulsatile

Distal - phasic with respiration

19
Q

When using duplex ultrasound for guidance for IVC filter placement, what vessel can be used as a marker to determine the correct level for filter placement?

A

RRA - filter is usually placed in the Rt CFV

20
Q

IVC filters are placed within the lumen of the IVC to prevent what?

A

Pulmonary emboli from lower extremity deep vein thrombosis

21
Q

Why is the RRA an important landmark in the placement of IVC filters?

A

It is the approximate level of the right renal veins

22
Q

Into what vessels is RCC likely to extend into and should be examined given this history?

A

IVC and renal veins

23
Q

IVC confluence of the L and R iliac veins begins at what level?

A

L5

24
Q

At what vertebrae does the IVC pass through the diaphragm?

A

T8

25
Q

What is the diameter of the IVC at the level of the renal veins?

A

17-20mm

26
Q

What is the measurement that denotes mega cava?

A

> 28mm

27
Q

With the absence of the intra-hepatic portion of the IVC, how is the blood returned to the heart?

A

Via azygos vein

28
Q

Where do left sided IVC’s drain into? (2)

A

Left renal vein or azygos vein

29
Q

On sonography, where do the hepatic veins appear to drain in the absence of an intra-hepatic IVC?

A

RA

30
Q

What is the nutcracker phenomenon?

A

Compression of LRV via SMA and Ao

31
Q

During inhalation, blood flows in which direction involving the thorax and abdominal cavity?

A

Blood flows from abdomen TO chest

32
Q

During exhalation, blood flows in which direction involving the thorax and abdominal cavity?

A

Blood flows from chest TO abdomen

33
Q

Loss of respiratory phasicity and inability to augment with distal thigh compression indicates what?

A

Proximal obstruction consistent with iliac vein thrombosis

34
Q

Intra-luminal tumors usually arise from where?

A

Hepatic or renal veins

35
Q

SF of a IVC tumour?

A
  1. Moderately echogenic
  2. Flow within mass
36
Q

What is May-Thurner’s syndrome?

A

Compression of the left iliac vein with the right iliac artery

37
Q

What is a caval fistula?

A

Abnormal connection between the IVC and other vessels

38
Q

Why type of device is used to protect patients from pulmonary emboli?

A

IVC filter

39
Q

Where are IVC filters typically placed?

A

Below the level of the renal veins

40
Q

What landmark by the IVC can help locate the level of the renal veins?

A

Right renal artery (it travels posterior to the IVC off the aorta and can be seen with a SA image of the mid IVC)

41
Q

The tip of the IVC filter is placed at what level?

A

The tip is at the level of the RRA

42
Q

What provides real-time images of the vein lumen with more detail and accuracy than duplex sonography or contrast venography?

A

Intravascular Ultrasound (IVUS)

43
Q

What type of colour flow is seen in a caval fistula?

A

Tissue Bruit (see slide 38)

vascular sonography (17 decks)

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