Vascular Ultrasound : How Why and When-3판

This book provides an understanding of the underlying scientific principles in the production of B-mode and Colour Flow
imaging and Spectral Doppler sonograms. A basic description of common vascular diseases is given along with a practical
guide as to how ultrasound is used to detect and quantify the disease. Possible treatments of common vascular diseases
and disorders are outlined. Ultrasound is often used in post-treatment assessment and this is also discussed. The role
of ultrasound in the formation and follow-up of haemodialysis access is a growing field and is covered in detail.

Key Features

■Practical step-by-step guide to peripheral vasular ultrasound.
■Explains the basic scientific principles of ultrasound instrumention and blood flow.
■Fully illustrated with 175 black and white scans, 150 colour scans and 220 black and white and colour line drawings.
■Contributions from leading names in peripheral vascular ultrasound.



1 Introduction
2 Ultrasound and imaging

INTRODUCTION
NATURE OF ULTRASOUND
GENERATION OF ULTRASOUND WAVES
INTERACTION OF ULTRASOUND WITH SURFACES
LOSS OF ULTRASOUND ENERGY IN TISSUE
PRODUCING AN ULTRASOUND IMAGE
AMPLIFICATION OF RECEIVED ULTRASOUND ECHOES
DYNAMIC RANGE, COMPRESSION CURVES, AND GRAY-SCALE MAPS
TRANSDUCER DESIGNS AND BEAM-FORMING
FOCUSING THE BEAM
IMAGE RESOLUTION
TISSUE HARMONIC IMAGING
References
Further reading

3 Doppler ultrasound

THE DOPPLER EFFECT
DOPPLER EFFECT APPLIED TO VASCULAR ULTRASOUND
EXTRACTING THE DOPPLER SIGNAL
ANALYSIS OF THE DOPPLER SIGNAL
DUPLEX ULTRASOUND
Reference
Further reading

4 Creation of a color flow image

INTRODUCTION
COLLECTION OF 2D DOPPLER INFORMATION
METHODS OF ESTIMATING THE VELOCITY OF BLOOD
ELEMENTS OF A COLOR FLOW SCANNER
EFFECT OF ANGLE OF INSONATION ON THE COLOR FLOW IMAGE
ALIASING IN COLOR FLOW IMAGING
LOWER AND UPPER LIMITS TO THE VELOCITY DISPLAYED
FRAME RATE
RESOLUTION AND SENSITIVITY OF COLOR FLOW IMAGING
POWER DOPPLER IMAGING
ENHANCED FLOW IMAGING USING CONTRAST AGENTS AND HARMONIC IMAGING
Reference
Further reading

5 Blood flow and its appearance on color flow imaging

INTRODUCTION
STRUCTURE OF VESSEL WALLS
WHY DOES BLOOD FLOW?
RESISTANCE TO FLOW
VELOCITY CHANGES WITHIN STENOSES
FLOW PROFILES IN NORMAL ARTERIES
FLOW THROUGH STENOSES
VENOUS FLOW
References

6 Factors that influence the Doppler spectrum

INTRODUCTION
FACTORS THAT INFLUENCE THE DOPPLER SPECTRUM
VELOCITY MEASUREMENTS
MEASUREMENT OF VOLUME FLOW
WAVEFORM ANALYSIS
References

7 Optimizing the scan

INTRODUCTION
THE PATIENT
STARTING THE SCAN
B-MODE CONTROLS
IMAGING ARTIFACTS
COLOR DOPPLER CONTROLS
COLOR IMAGING ARTIFACTS
SPECTRAL DOPPLER OPTIMIZATION
REPETITIVE STRAIN INJURY AND OCCUPATIONAL HAZARDS
SAFETY OF DIAGNOSTIC ULTRASOUND
References
Further reading

8 Ultrasound assessment of the extracranial cerebral circulation

INTRODUCTION
ANATOMY
SYMPTOMS OF CAROTID AND VERTEBRAL ARTERY DISEASE
SCANNING
B-MODE IMAGING
COLOR IMAGING
SPECTRAL DOPPLER WAVEFORMS
SELECTION OF TREATMENT FOR CAROTID ARTERY DISEASE
GRADING THE DISEASE
COMBINING B-MODE, COLOR IMAGING, AND SPECTRAL DOPPLER INFORMATION
NORMAL AND ABNORMAL APPEARANCES OF VERTEBRAL ARTERY FLOW
PROBLEMS ENCOUNTERED IN IMAGING CAROTID ARTERY FLOW
POSTOPERATIVE CAROTID ARTERY APPEARANCE ON ULTRASOUND
POST CAROTID ARTERY ANGIOPLASTY AND STENTING APPEARANCE ON ULTRASOUND
NONATHEROMATOUS CAROTID ARTERY DISEASES
TRANSCRANIAL DOPPLER ULTRASOUND
REPORTING
References
Further reading

9 Duplex assessment of lower-limb arterial disease

INTRODUCTION
ANATOMY OF THE LOWER-LIMB ARTERIAL SYSTEM
SYMPTOMS OF LOWER-LIMB ARTERIAL DISEASE
DISEASE PATTERNS AND LOWER-LIMB WAVEFORM SHAPES
ANKLE BRACHIAL PRESSURE MEASUREMENTS AND EXERCISE TESTING
PRACTICAL CONSIDERATIONS FOR LOWER-EXTREMITY DUPLEX SCANNING
STARTING THE SCAN
SCAN APPEARANCES
SPECIALIZED APPLICATIONS
ASSESSMENT OF ARTERIAL STENTS
OTHER ABNORMALITIES AND SYNDROMES
REPORTING
References
Further reading

10 Duplex assessment of upper-limb arterial disease

INTRODUCTION
ANATOMY OF THE UPPER-EXTREMITY ARTERIES
SYMPTOMS AND TREATMENT OF UPPER-LIMB ARTERIAL DISEASE
PRACTICAL CONSIDERATIONS FOR DUPLEX ASSESSMENT OF UPPER-EXTREMITY ARTERIAL DISEASE
SCANNING TECHNIQUES
ULTRASOUND APPEARANCE
THORACIC OUTLET SYNDROME
ANEURYSMS
OTHER DISORDERS OF THE UPPER-EXTREMITY CIRCULATION
REPORTING
References
Further reading

11 Duplex assessment of aneurysms and endovascular repair

INTRODUCTION
ANATOMY OF THE ABDOMINAL AORTA
PATHOLOGY OF ANEURYSMS
ANEURYSM SHAPES AND TYPES
AORTIC ANEURYSMS: SYMPTOMS AND TREATMENT
PRACTICAL CONSIDERATIONS FOR DUPLEX SCANNING OF AORTIC ANEURYSMS
SCANNING TECHNIQUE
ULTRASOUND APPEARANCE
MEASUREMENTS
SURVEILLANCE OF ENDOVASCULAR ANEURYSM REPAIR
OTHER TRUE ANEURYSMS
FALSE ANEURYSMS
References

12 Vascular ultrasound of abdominal aortic branches

INTRODUCTION
DOPPLER INVESTIGATION OF NATIVE KIDNEYS
RENAL VASCULAR ANATOMY, HEMODYNAMICS, AND DOPPLER APPEARANCE
SCANNING THE RENAL VASCULATURE
ABNORMAL RESULTS
RENAL TRANSPLANTS
CELIAC AXIS AND MESENTERIC ARTERIES
REPORTING
References

13 Anatomy of the lower-limb venous system and assessment of venous insufficiency

INTRODUCTION
ANATOMY AND PHYSIOLOGY
VENOUS DISORDERS AND TREATMENT
PRACTICAL CONSIDERATIONS FOR DUPLEX SCANNING OF VARICOSE VEINS
AUGMENTATION MANEUVERS AND VENOUS REFLUX
GRADING OF SUPERFICIAL AND DEEP VENOUS REFLUX
SCANNING PROTOCOL FOR THE LOWER-LIMB VENOUS SYSTEM
INVESTIGATION OF RECURRENT VARICOSE VEINS
ASSESSMENT OF PATIENTS WITH SKIN CHANGES AND VENOUS ULCERATION
ENDOVENOUS ABLATION OF VARICOSE VEINS
FOAM SCLEROTHERAPY
OTHER DISORDERS OF THE VENOUS SYSTEM
REPORTING
References
Further reading

14 Duplex assessment of deep venous thrombosis and upper-limb venous disorders

INTRODUCTION
EPIDEMIOLOGY AND PATHOLOGY OF DVT
PRACTICAL CONSIDERATIONS FOR DUPLEX ASSESSMENT OF DVT
DEEP-VEIN EXAMINATION FOR ACUTE DVT
SCAN APPEARANCES FOR THE ASSESSMENT OF DVT
ACCURACY OF DUPLEX SCANNING FOR THE DETECTION OF DVT
NATURAL HISTORY OF DVT
OTHER PATHOLOGIC CONDITIONS THAT CAN MIMIC DVT
UPPER-LIMB VEINS
TECHNIQUE FOR ASSESSING THE BRACHIAL, AXILLARY, AND SUBCLAVIAN VEINS
REPORTING
References
Further reading

15 Graft surveillance and preoperative vein mapping for bypass surgery

INTRODUCTION
ANATOMY
PURPOSE OF GRAFT SURVEILLANCE
SYMPTOMS AND TREATMENT OF GRAFT STENOSIS OR FAILURE
PRACTICAL CONSIDERATIONS FOR SCANNING BYPASS GRAFTS
SCANNING TECHNIQUES
B-MODE IMAGES
COLOR DOPPLER IMAGES
SPECTRAL DOPPLER WAVEFORMS
GRAFT FAILURE AND OCCLUSION
COMMONLY ENCOUNTERED PROBLEMS
TRUE AND FALSE ANEURYSMS
ENTRAPMENT OF GRAFTS
ARTERIOVENOUS FISTULAS
SEROMAS, FLUID COLLECTIONS, AND GRAFT INFECTIONS
REPORTING
SUPERFICIAL VEIN MAPPING FOR ARTERIAL BYPASS SURGERY
References

16 Ultrasound of hemodialysis access

INTRODUCTION
HEMODIALYSIS ACCESS
PERMANENT ACCESS
REPORTING
References
Appendix A Decibel scale
Appendix B Sensitivity and specificity
Further reading
Index