Chapter 13 Duplex/ Flow Imaging Abdomen

Question 1

What is the purpose of evaluating the aorto-iliac vessels

Answer 1

Evaluate vessels for stenosis, status of bypass grafts and aneurysmal disease

Question 2

The renal arteries to evaluated to document a ________% diameter reduction

Answer 2

> 60%

Question 3

Why are the kidneys evaluated

Answer 3

To help in the evaluation of nephrosclerotic disease

Question 4

Why are the mesenteric arteries evaluated

Answer 4

To document significant stenosis or evaluation of mesenteric bowel ischemia

Question 5

Why is the liver evaluated

Answer 5

For suspected portal hypertension and pre/post liver transplants

Question 6

In the aorto iliac arteries a dilation of 3 cm or an increase in diameter of 50% or greater than the original artery is a sign of an

Answer 6

Aneurysm

Question 7

The majority of AAAs are _______ and ________

Answer 7

Atherosclerotic and infrarenal

Question 8

What is the most frequent complication of the aorto iliac arteries

Answer 8

Rupture of the aortic aneurysm

Question 9

Many patients who have hypertension have ___________ hypertension

Answer 9

Renovascular

Question 10

Renovascular hypertension is usually caused from _________ or _______

Answer 10

Renal artery stenosis, occlusion

Question 11

The renal arteries and kidney arteries are

A) high resistant
B) low resistant

Answer 11

B) low resistant

Question 12

Name 3 arteries that are low resistant

Answer 12

1) celiac
2) hepatic
3) splenic

Question 13

The aorta is usually

A) high resistant
B) low resistant

Answer 13

A) high resistant

Question 14

Name 2 arteries that are high resistive

Answer 14

Fasting SMA and IMA

Question 15

How do you calculate the renal to aortic ratio (RAR)

Answer 15

Highest renal artery PSV/ aorta PSV

Question 16

What is a normal RAR

Answer 16

< 3.5

Question 17

What is an abnormal RAR

Answer 17

> 3.5

Question 18

An RAR of > 3.5 suggest

Answer 18

> 60% of diameter reduction

Question 19

What are the 2 reasons one can’t use the RAR

Answer 19

1) if AAA is detected
2) if aortic PSV > 90 cm/s or < 40 cm/s

Question 20

What is the normal length of the adult kidneys

Answer 20

10-12 cm

Question 21

How do you calculate the end diastolic ratio (EDR)

Answer 21

End diastolic V/ PSV

Question 22

What is a normal EDR value

Answer 22

> 0.2

Question 23

What does EDR stand for

Answer 23

End diastolic ratio

Question 24

What is an abnormal EDR

Answer 24

< 0.2

Question 25

How do you calculate the RI

Answer 25

PSV-EDV/ PSV

Question 26

What is a normal RI

Answer 26

<0.75

Question 27

What is an abnormal RI

Answer 27

>0.75

Question 28

Proximal high grade stenosis/ occlusion of renal artery may result in _________ _______ Doppler signals distally

Answer 28

Dampened, weak

Question 29

Patients presenting with a history of dull, achy or crampy abdominal areas sun 15-30 minutes after meals are suspected for

Answer 29

Mesenteric ischemia

Question 30

The pain for mesenteric ischemia is also known as

Answer 30

Mesenteric angina

Question 31

What is the PSV, EDV and flow reversal of the SMA of a pre-prandial fasting patient

Answer 31

PSV- high EDV- low Flow reversal- yes

Question 32

What is the PSV,EDV, and flow reversal of the celiac in a pre-prandial fasting patient

Answer 32

PSV- high EDV- high Flow reversal- no

Question 33

What is the PSV, EDV, and loss of flow reversal in the SMA of a post-prandial patient

Answer 33

PSV- marked increase EDV- marked increase Loss of flow reversal- yes

Question 34

What is the PSV, EDV, and loss of flow reversal in the celiac of a post- prandial patient

Answer 34

PSV- no change EDV- no change Loss of flow reversal- N/A

Question 35

What is the normal PSV of the SMA

Answer 35

110-177 cm/sec

Question 36

What is the normal PSV of the celiac

Answer 36

50-160 cm/sec

Question 37

If there is a stenosis in the SMA the PSV is _______ and predicts a ______% diameter reduction

Answer 37

>275 and 70%

Question 38

If there is a stenosis in the celiac the PSV is _______ and predicts a ________ diameter reduction

Answer 38

>200 cm/sec and 70%

Question 39

In most cases _____ of _____ mesenteric vessels have to be abnormal to be consistent with chronic mesenteric ischemia

Answer 39

2 of 3

Question 40

Extrinsic compression of the celiac artery origin by the

Answer 40

Median arcuate ligament

Question 41

What transducer frequency would you use for an organ transplant allograft

Answer 41

5 or 3 MHz

Question 42

Pre and post operative evaluation of a liver transplant include documenting patency of what 4 things

Answer 42

1) portal vein 2) hepatic veins 3) IVC 4) hepatic artery

Question 43

What transducer frequency should be used for a renal transplant

Answer 43

5 MHz

Question 44

A transplanted renal artery is anastomosed to what

Answer 44

EIA or IIA

Question 45

A transplanted RV is anastomosed to the

Answer 45

EIV

Question 46

What are the 2 signs of B-mode renal transplant rejection

Answer 46

1) increased renal transplant size 2) increased cortical echogenicity

Question 47

What is the most reliable method for renal transplant rejection diagnosis

Answer 47

Biopsy