Vascular, Cardiac, and MSS Ultrasound

Vascular ultrasound

morphologic image combined with velocity of flow

Doppler spectral waveform

Provides information about blood flow velocity, flow direction, presence of flow disturbance or turbulence, and vascular impedance.

Velocity over time

Doppler spectral waveform displays...

above

flow towards the transducer appears ____ the baseline on doppler spectral waveform

below

flow away from the transducer appears ____ the baseline on doppler spectral waveform

Arteries

have a sharp increase with little backflow on Doppler spectral waveform

Veins

have flow mostly below baseline, rate slower, and not as sharp, also don't have backflow on Doppler spectral waveform

velocity increases

to maintain blood volume on both sides of the plaque, velocity has to increase in the narrowed area.

On Doppler spectral waveform, what change do we see in a vessel with atherosclerosis?

Veins

vessels that are larger and compressible on vascular ultrasound

arteries

vessels that are round and non-compressible on vascular ultrasound

Long View of Carotid Artery with Atherosclerotic Plaque

Trans view of Carotid Artery with Atherosclerotic plaque

Long View of Normal Aorta

Trans view of normal aorta

Abdominal Aortic Aneurysm

AAA

Aortic Dissection

Peripheral arterial disease (PAD)

claudication or pain with exertion should make you suspect...

ABI

PAD is quantified by _______

ABI

systolic BP ankle/systolic BP brachial

equal

normally systolic BPs should be about ____ in ankle and arm

0.5 or less

ABI of _______ is indicative of severe arterial disease.

velocity increases

as vessel diameter narrows _________. Difference between transmitted and reflected sound velocity increases with increase in velocity.

symptomatic

DVT ultrasound is more sensitive in ____ patients

- Common femoral vein

- Proximal deep femoral

- Greater saphenous

- Femoral vein

- Popliteal vein

- Posterior tibial and peroneal veins

DVT ultrasound is performed along certain anatomic landmarks including...

- thrombotic vein will not compress

- thrombus appears echogenic

What are we looking for on DVT ultrasound?

DVT present

On this ultrasound, you are applying pressure to compress this vein. What is the diagnosis?

DVT absent

On this ultrasound, you are applying pressure to compress this vein. What is the diagnosis?

hyperechoic

normal tendons appear ____ with fiber type echotexture (rope appearance)

hypoechoic

Muscle tissue is ____ to the tendon.

hyperechoic

bone surface is very _____ with posterior shadowing

hypoechoic

hyaline cartilage covering articular surface of the bone is _____

hyperechoic

fibrocartilage (labrum and menisci) are ______

hyperechoic

but may appear hypoechoic if surrounded by fat

ligaments are _______ with striated appearance and more compact than tendons connecting two osseous structures.

Long view of a normal tendon

Trans view of a normal tendon

Long view of patellar tendon

Anechoic patellar tendon --> inflammation going on

- Parasternal

- Apical

- Subcostal

- Suprasternal notch

Acoustic windows for Cardiac Echo...