Interpretation of Venous Duplex Imaging

What is this image showing?

acute blood clot

What is this image showing?

chronic blood clot

-the vein is almost completely occluded

What is this image showing?

chronic blood clot

Blood clots are commonly formed by the?

valves

What is this image showing?

blood clot by a venous catheter 

What is the purpose of venous reflux testing?

is to identify the presence and location of incompetent venous valves

Patients that suffer from chronic venous insufficiency may benefit from

study

Symptoms of venous reflux include:

-chronic leg swelling

-induration (leathery skin, hard)

-sometimes ulcers

What is this image showing?

venous reflux

we do not want it to flow backwards or reflux 

What is the purpose of superficial vein mapping?

is to determine vein’s suitability for use as bypass conduit and to identify its anatomic route

superficial vein mapping is usually performed before

lower extremity arterial bypass or coronary bypass operations, a-v fistula for dialysis

Information gathered about the superficial vein include:

• vein patency

• position

• depth

• size 

Vein mapping allows for

selection of optimal vein used for surgery

adequate vein diameter may vary based on

surgeon preference and intended use of the vein

Generally, most surgeons will not 

use a vein with a diameter of less than 2 mm

Most surgeons prefer vein diameter of

2.5 to 3 mm

smaller veins may be prone to spasm and are difficult to suture

What is the bakers cyst also called?

popliteal cyst

What is a baker cyst?

fluid collection that can be found in the popliteal fossa

The bakers cyst is a ____________ bursa

communicating bursa

Excess fluid can be related to 

any type of arthritis 

trauma or tears can affect the baker cyst

What is this image showing?

bakers cyst

Bakers cyst can be

unilateral or bilateral

Symptoms of bakers cyst can mimic 

DVT symptoms include swelling and tightness behind the knee, or severe pain in the upper calf in cases of cyst rupture and dissection into the upper calf muscles 

What are other pathologies:

-abscesses

-cellulitis

-hematomas

can cause focal areas of redness and swelling that may mimic symptoms of DVT

Cellulitis is caused by

a bacterial infection

Proving no ________ in deep venous system is first goal; evaluating _______ _______ is secondary goal

DVT

focal area

Small fluid collections may be seen within

tissue or muscle planes

What is this image showing?

a hematoma 

What is this image showing?

a abscess

What are the characteristics of an abscess?

elevated WBC, fever, red, and hot to the touch

What can sometimes be mistaken for DVT in common femoral or external iliac veins?

lymph nodes

Lymph nodes are very common in

in the groin

Visualizing lymph nodes in transverse and sagittal excludes them from

venous pathology 

Enlarged lymph nodes should be

documented when seen

What is this image showing?

lymph node

What is this image showing?

cellulitis/edema