US

Question 1

right groin US image with color doppler. What intervention did the pt likely have, diagnosis, and what is the treatment?

Answer 1

femoral artery pseudoaneurysm with classic “yin-yang” sign indicated to and fro flow into and out fo the pseudoaneurysm sac.

likely right femoral arterial access recently (like heart cath)

treatment = ultrasound guided thrombin injection. GOAL: introduce thrombogenic material under sonographic visualization to eleimate visible flow within the pseudoaneurysm sac

Question 2

Answer 2

tardus parvus waveform. PROXIMAL stenosis

Question 3

If shown BILATERAL parvus tardus in the carotids:

Answer 3

aortic stenosis

Question 4

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Question 5

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Question 6

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Question 7

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Question 8

if you are given a doppler US of the vertebral artery. most likely diagnosis?

Answer 8

subclavian steal.

Question 9

Resistive Index equation

Answer 9

RI = (PSV - EDV)/PSV

Question 10

higher diastolic flow is seen in what arteries?

Answer 10

carotid and vertebral artries (lower resistance waveforms –> lower RI)

Question 11

lower diastolic flow is seen in what vessels?

Answer 11

extremities

lower diastolic flow = higher resistance waveform (higher RI)

due to elastic recoil.

retrograde flow may be seen in early diastole (triphasic flow)

Question 12

both of these are normal waveforms. Which is an upper and which is a lower extremity vein?

Answer 12

Question 13

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Question 14

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Question 15

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Question 16

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Question 17

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Question 18

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Question 19

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Question 20

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Question 21

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Question 22

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Question 23

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Question 24

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Question 25

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Question 26

what is the single most reliable parameter for differentiating the ECA from the ICA if only a single vessel is identified distal to the carotid bulb?

Answer 26

temporal tap maneuver

. The temporal tap maneuver involves tapping on the superficial temporal artery and looking for reflected flow in the ECA.

https://pubs.rsna.org/doi/pdf/10.1148/rg.256045013

Question 27

Answer 27

ICA occlusion

Question 28

Nyquist limit =

Answer 28

1/2 (PRF)

Question 29

How do you fix this?

Answer 29

Things you can do to fix aliasing:

• Can increase velocity scale
• Change the baseline setting
• Lower frequency doppler probe

Question 30

Answer 30

Question 31

what happens as you increase the gate size to the spectral window?

Answer 31

you get spectral broadening if you increase the size of the gate.

wider gate = more and more sampling of frequency shifts

Question 32

cd image corresponds to what phase of the cardiac cycle?

Answer 32

late systole

Question 33

color doppler image corresponds to what phase of the cardiac cycle

Answer 33

peak systole

Question 34

this color doppler image corresponds to what phase of the cardiac cycle?

Answer 34

early diastole

Question 35

this color doppler image corresponds to what phase of the cardiac cycle?

Answer 35

mid/late diastole

Question 36

Answer 36

>70% stenosis

because there is still diastolic flow this is not near total occlusion

Question 37

Dosing of US guided thrombin injection for arterial pseudoaneurysm

Answer 37

100-1000IU

mean dose of approximately 300 IU