New Waveform recognition/ Pitfalls and difficult cases

Question 1

Thickening of intima-media thickness if strongly associated with?

Answer 1

atherosclerosis

Question 2

An IMT greater than ____ is indicatice of increased risk of cardiovascular disease?

Answer 2

0.9-1mm

Question 3

ICA vs. ECA vessel waveform?

Answer 3

ICA- lower pulsatility –window-high diastolic flow

ECA-higher pulsatility-higher upstroke-closer to baseline-relatively lower diastolic flow

Question 4

Internalization of the cca?

Answer 4

ICA complete occlusion
All of the CCA flow will enter the ECA
ECA is a high resistant vascular bed
Usually the CCA supplies a low(ICA) and high resistant bed(ECA)
Its flow under normal circumstances is a blend of low and high resistance flow patterns
If the ICA low resistant bed is occluded,then all of the flow enters the ECA
It takes on a higher resistant flow pattern as a result

Question 4

Internalization of the ECA?

Answer 4

When the ICA is totally occluded,all of the CCA flow enters the ECA
The ECA will become a lower resistant flow pattern, immitating the ICA flow pattern
The OA will have reversed flow to supply the portion of the brain without flow from the occluded extracranial ICA

Question 5

Tachycardia?

Answer 5

Heart > 100 bpm

decreased PSV

Question 6

Bradycardia?

Answer 6

Heart rate <60bpm

increased PSV

Question 7

Arrhythmia?

Answer 7

Irregular heart rate

Question 8

Tortuous ICA colour box?

Answer 8

In vertical portions remove angle correct and shoot straight down the tube

Question 9

What to do with doppler in low flow states/ trickle flow?

Answer 9

Lower the PRF
Increase the color gain
Use power doppler(not useful for directional flow,only presence of flow)

Question 10

Power doppler is usefull in detecting flow in low flow state situations including? (7)

Answer 10

Small Vertebral A
Trickle flow
Overall low heart rate
High bifurcation-carotids
Renal doppler
Ovarian and testicular assessment
Nodal flow