Ch 14: Duplex/ Color Scanning Abdominal Vessels

Duplex/Color scanning abdominal vessels capabilities

eval stenosis and disease of aortoiliac, renal, mesenteric, and hepatic vessels.

Duplex/Color scanning abdominal vessels limitations

body habitus, bowel gas, scar tissue, rapid respirations

aneurysm size

>3cm or >50% increase in size from adjacent segment

majority of AAA are _____ and _____

atherosclerotic, infrarenal

AAA major complication

rupture

peripheral aneurysm major complication

embolization

Renal artery stenosis can be secondary to

atherosclerosis or fibromuscular dysplasia

renovasclar hypertension

decreased flow to kidneys triggers kidneys to produce renin which promotes conversion of angiotensinogen to angiotensin which increased BP

RRA relation to Aorta

anterolateral

Renal arteries and intrarenal arteries are ______ while the Aorta is ______

low resistance, high resistance

RAR

renal artery PSV/Aorta PSV

RAR normal values

<3.5

RAR is not accurate

AAA or Ao PSV is <40 or 90< cm/s

Renal artery velocity that indicates a 60< diameter reduction

180-200 cm/s

kidney size

10-12 cm

End-diastolic Ratio AKA

Parenchymal resistance ratio (PRR) or diastolic/systolic ratio (DSR) AKA

EDR normal value

>0.2

EDR

EDV/ PSV

RI normal value

<0.7

RI

PSV-EDV/PSV

dampened upstroke in intrarenal arteries

prox high grade stenosis or occlusion

>100 msec acceleration time

can indicate a prox stenosis of >60% diameter reduction

mesenteric ischemia dx

arteriogram

pre-prandial SMA is _____ while post-prandial SMA is _____

high resistance, low resistance

SMA normal PSV

100-117 cm/s

SMA abnormal PSV

>275 cm/s

IMA collateral connections

Arc of Riolan and Marginal Artery of the Colon/ Drummond

chronic mesenteric ischemia

2/3 mesenteric vessels are abnormal

CA is a ______ vessel

low resistance

CA normal PSV

50-160 cm/s

CA abnormal PSV

>200 cm/s

Arcuate Ligament Compression Syndrome AKA

Celiac Axis Compression Syndrome AKA

CA Compression syndrome

MC in women

velocities in CA compression syndrome improve w/ _____ and return w/ _____

inspiration,expiration

renal failure leading to renal transplant

diabetes is the MC cause

where donor kidneys are implanted

MC site is rt iliac fossa

transplant Renal arteries are anastamosed

end to side EIA or end to end IIA

transplant Renal veins are anastamosed

end to end EIV

signs of renal transplant rejection

increase in renal size, loss of corticomedullary differentiation, hypoechoic regions in parenchyma, increase in arterial resistance

MC cause of liver transplant in adults

cirrhosis

MC cause of liver transplant in children

biliary atresia

PV thrombosis

can make liver transplant difficult or impossible

post-op PV size

1.3-1.5 cm