1
Q
What does B-Mode show in USG Doppler?
A
B-Mode shows structure only, using gray-scale for basic organ anatomy and standard imaging.
2
Q
What is the color code for Color Doppler (CFI) when flow is toward the transducer?
A
Red indicates flow toward the transducer in Color Doppler (CFI).
3
Q
What is the color code for Color Doppler (CFI) when flow is away from the transducer?
A
Blue indicates flow away from the transducer in Color Doppler (CFI).
4
Q
What is Spectral Doppler used for?
A
Spectral Doppler is used for velocity waveform analysis, RI calculation, and stenosis assessment in arterial/venous analysis.
5
Q
What does Duplex mode combine?
A
Duplex mode combines B-mode and Color Doppler for vessel assessment, particularly in peripheral arterial disease.
6
Q
What does Triplex mode combine?
A
Triplex mode combines B-mode, Color Doppler, and Spectral Doppler for advanced hemodynamics and high-accuracy vascular diagnosis.
7
Q
What is the mnemonic for remembering USG Doppler modes?
A
B-Mode = Basic; Color = direction; Spectral = Speed; Duplex = Double; Triplex = Triple.
8
Q
What is characteristic of a Triphasic Waveform in normal arteries of the extremities?
A
A Triphasic waveform has a systolic peak (upward), a brief reversal of diastolic flow (downward), and then a resumption of forward end-diastolic flow (upward).
9
Q
What does the systolic phase of a Triphasic waveform represent?
A
The systolic phase represents contraction with forward flow, indicating high velocity and maximum flow.
10
Q
What does the early diastolic phase of a Triphasic waveform represent?
A
The early diastolic phase shows reversal of flow, indicating elastic recoil and backward flow.
11
Q
What does the end-diastolic phase of a Triphasic waveform represent?
A
The end-diastolic phase shows minimal forward flow resumption.
12
Q
What is the IOC (Intraoperative Cholangiography) for normal healthy peripheral arteries?
A
The IOC for normal healthy peripheral arteries (iliac, femoral, popliteal) is a Triphasic waveform.
13
Q
What is the mnemonic for remembering Triphasic waveforms?
A
Triphasic = Healthy arteries (3 phases = normal).
14
Q
What information does Color Doppler (CFI) provide?
A
Color Doppler (CFI) shows flow direction and speed.
15
Q
What is Spectral Doppler used to calculate?
A
Spectral Doppler is used for RI (Resistive Index) calculation.
16
Q
What condition is Duplex Doppler particularly useful for assessing?
A
Duplex Doppler is useful for assessing peripheral arterial disease.
17
Q
What type of diagnosis does Triplex mode facilitate?
A
Triplex mode facilitates high-accuracy vascular diagnosis.
18
Q
Describe the appearance of a Triphasic waveform.
A
A Triphasic waveform has an upward systolic peak, a downward brief reversal in early diastole, and an upward resumption of flow in late diastole.
19
Q
What does the upward deflection in a Triphasic waveform indicate?
A
The upward deflection in a Triphasic waveform indicates forward flow.
20
Q
What does the downward deflection in a Triphasic waveform indicate?
A
The downward deflection in a Triphasic waveform indicates reversed flow.
21
Q
What is the characteristic appearance of a biphasic waveform in moderate stenosis/disease?
A
A biphasic waveform shows a systolic peak followed by a reduced or absent diastolic reversal, with forward flow present at the end-diastole.
22
Q
What does the ‘minimal reversal’ indicate in the context of a biphasic waveform?
A
Minimal reversal in a biphasic waveform suggests increased downstream resistance or moderate stenosis.
23
Q
What is the typical finding for the systolic peak in a biphasic waveform with moderate stenosis?
A
The systolic peak is present and shows good velocity.
24
Q
What is the status of diastolic reversal in a biphasic waveform associated with moderate stenosis?
A
Diastolic reversal is reduced or absent.
25
What is the meaning of the loss of diastolic reversal in a biphasic waveform?
Loss of diastolic reversal indicates increased downstream resistance or moderate stenosis.
26
What is the interpretation of a biphasic waveform with reduced or absent diastolic reversal?
It indicates moderate arterial disease, typically corresponding to 40-60% stenosis.
27
Describe the appearance of a monophasic waveform in severe stenosis/disease.
A monophasic waveform is characterized by a blunted/flattened systolic peak, absent diastolic reversal, and continuous forward flow throughout the cardiac cycle.
28
What is the systolic peak like in a monophasic waveform indicating severe stenosis?
The systolic peak is blunted or flattened.
29
What is the finding for diastolic reversal in a monophasic waveform?
Diastolic reversal is absent.
30
What does 'continuous forward flow' throughout the cardiac cycle signify in a monophasic waveform?
Continuous forward flow throughout the cardiac cycle in a monophasic waveform signifies severe stenosis (greater than 70%) or severe downstream disease.
31
What does a monophasic waveform with absent diastolic reversal and continuous forward flow imply?
It implies severe stenosis (greater than 70%) or severe downstream disease.
32
What is the difference in diastolic flow between a biphasic and a monophasic waveform in the context of stenosis?
A biphasic waveform shows reduced or absent diastolic reversal, while a monophasic waveform shows absent diastolic reversal and continuous forward flow.
33
What percentage of stenosis is typically associated with moderate arterial disease indicated by a biphasic waveform?
Moderate arterial disease, indicated by a biphasic waveform, is typically associated with 40-60% stenosis.
34
What percentage of stenosis is typically associated with severe disease indicated by a monophasic waveform?
Severe disease, indicated by a monophasic waveform, is typically associated with greater than 70% stenosis.
35
What does severe stenosis (>70%) or severe downstream disease indicate in Doppler interpretation?
It indicates critical arterial stenosis, a post-stenotic waveform, or distal disease.
36
What is the mnemonic for remembering that a monophasic waveform signifies severe disease?
Monophasic = Only one phase = Severe disease.
37
How do arterial waveforms typically appear on Doppler compared to venous waveforms?
Arterial waveforms are pulsatile (triphasic/biphasic), while venous waveforms are monophasic (continuous).
38
Describe the flow character of arteries and veins on Doppler.
Arteries have pulsatile flow with multiple peaks, whereas veins have continuous, smooth flow.
39
How does compressibility differ between arteries and veins on Doppler?
Arteries are non-compressible, while veins are compressible.
40
What are the characteristics of spectral Doppler for arteries versus veins?
Arteries show high velocity that varies with systole/diastole, while veins show low, steady velocity.
41
What is the effect of probe pressure on augmentation for arteries and veins?
There is no change with probe pressure for arteries, but there is increased flow with proximal compression for veins.
42
What is the mnemonic for distinguishing arteries and veins on Doppler based on waveform?
Artery = Pulsatile (triphasic); Vein = Smooth (monophasic).
43
What is the formula for calculating the Resistive Index (RI)?
Resistive Index (RI) = Peak Systolic Velocity (PSV) − End Diastolic Velocity (EDV) / PSV.
44
What does a high Resistive Index (RI) typically suggest?
A high RI often suggests significant downstream resistance or disease.
45
What does a low Resistive Index (RI) typically suggest?
A low RI generally indicates low downstream resistance, often seen in organs with continuous blood supply.
46
What is the normal Resistive Index (RI) range for the renal artery?
The normal RI range for the renal artery is <0.70.
47
What does an RI >0.70 in the renal artery suggest?
An RI >0.70 in the renal artery suggests suspected renal artery stenosis.
48
What is the normal RI for the portal vein?
The normal RI for the portal vein is <0.5.
49
What does a normal RI in the portal vein indicate?
A normal RI in the portal vein indicates normal liver perfusion.
50
What is the normal RI for the umbilical artery during pregnancy?
The normal RI for the umbilical artery during pregnancy is <0.75.
51
What does an elevated umbilical artery RI during pregnancy suggest?
An elevated umbilical artery RI during pregnancy suggests a high-risk pregnancy.
52
What is the normal RI for cerebral arteries?
The normal RI for cerebral arteries is <0.75.
53
What does a normal RI in cerebral arteries indicate?
A normal RI in cerebral arteries indicates normal cerebral perfusion.
54
What is the general mnemonic for a 'red flag' for stenosis regarding RI?
The mnemonic is 'RI >0.7 = Red flag for stenosis'.
55
In the context of renal arteries, what RI value indicates no stenosis?
An RI <0.70 indicates no stenosis and patent, good perfusion.
56
What RI value is associated with high-grade renal artery stenosis (RAS >60%)?
An RI >0.80 is associated with high-grade renal artery stenosis.
57
What finding on Doppler can indicate acute transplant rejection?
Elevated RI, specifically loss of diastolic flow, can indicate acute transplant rejection.
58
What RI value is often seen in diabetic nephropathy (chronic kidney disease)?
An elevated RI, often >0.8, is seen in diabetic nephropathy.
59
What RI value suggests increased vascular resistance in portal hypertension (cirrhosis)?
An RI >0.5 suggests increased vascular resistance in portal hypertension.
60
What is a key Doppler diagnostic criterion for DVT related to vein compressibility?
In a normal vein, it is completely compressible. In DVT, it is non-compressible. This has a specificity of 95-98%.
61
How does flow on Doppler differ between a normal vein and a vein with DVT?
In a normal vein, flow is monophasic and continuous. In DVT, there is no flow signal.
62
What is the Doppler finding for augmentation in a normal vein versus a vein with DVT?
In a normal vein, there is increased flow with proximal compression (augmentation). In DVT, augmentation is absent.
63
Describe the B-mode appearance of a normal vein versus a vein with DVT.
A normal vein appears anechoic (empty). A vein with DVT appears echogenic (clot visible).
64
What is the primary imaging modality for the diagnosis of Deep Vein Thrombosis (DVT)?
Doppler ultrasound is the first-line imaging modality for DVT diagnosis.
65
What are the key diagnostic criteria for DVT based on Doppler ultrasound?
The key criteria are a non-compressible vein and absent flow on Doppler.
66
In a normal vein, what is observed regarding compressibility during a Doppler ultrasound?
A normal vein is completely compressible.
67
What is observed regarding compressibility in a vein affected by DVT?
A vein affected by DVT is non-compressible.
68
What is the typical flow pattern observed in a normal vein on Doppler ultrasound?
Flow in a normal vein is monophasic and continuous.
69
What is observed regarding flow on Doppler ultrasound in a vein with DVT?
There is no flow signal detected on Doppler in a vein with DVT.
70
What is the augmentation response with proximal compression in a normal vein?
There is increased flow with proximal compression in a normal vein.
71
What is the augmentation response with proximal compression in a vein with DVT?
Augmentation is absent in a vein with DVT.
72
What is the B-mode appearance of a normal vein?
A normal vein appears anechoic (empty).
73
What is the B-mode appearance of a vein with DVT?
A vein with DVT appears echogenic (clot is visible).
74
What is the specificity for compressibility as a diagnostic criterion for DVT?
The specificity for compressibility is 95-98%.
75
What is the mnemonic provided for remembering the Doppler diagnosis of DVT?
DVT = Doppler (non-compressible + no flow = diagnosis).
76
In the Femoral/Popliteal DVT Protocol, what is the initial patient position?
The patient is in a supine position.
77
What type of ultrasound probe is typically used for DVT assessment, and why?
A linear probe (higher frequency) is used for DVT assessment.
78
In the Femoral/Popliteal DVT Protocol, what is the initial view obtained with the probe?
An initial transverse view is obtained to assess compressibility.
79
After assessing compressibility, what view is used to assess flow in the Femoral/Popliteal DVT Protocol?
A longitudinal view is used to assess flow.
80
What is the SFJ and what does it represent in ultrasound imaging?
SFJ stands for Saphenofemoral junction, where the saphenous vein meets the femoral vein.
81
What is the CFV and its anatomical relationship to the CFA?
CFV stands for Common femoral vein, and it is located medial to the Common femoral artery (CFA).
82
What is the CFA and its anatomical relationship to the CFV?
CFA stands for Common femoral artery, and it is located lateral to the Common femoral vein (CFV).
83
Describe the compressibility test for DVT.
Gentle pressure is applied with the probe. A normal vein collapses, while a DVT vein remains patent.
84
What is the management for a triphasic waveform in Peripheral Arterial Disease (PAD) screening using Doppler USG?
No intervention is needed for a triphasic waveform.
85
What stenosis grade is associated with a biphasic waveform in PAD screening?
A biphasic waveform indicates moderate stenosis (40-60%).
86
What is the recommended management for a monophasic waveform in PAD screening?
Intervention is indicated for a monophasic waveform, which suggests severe stenosis (>70%).
87
What is the role of Doppler USG in the context of PAD screening?
Doppler USG is used for peripheral arterial disease screening.
88
What diagnosis is suggested by a pulsatile mass with normal Doppler flow?
A pulsatile mass with normal Doppler flow suggests an Abdominal Aortic Aneurysm (AAA) or a vascular mass.
89
What imaging modality is used to confirm an AAA diagnosis when a pulsatile mass and normal Doppler flow are present?
Doppler USG is used to confirm the AAA diagnosis.
90
What is the initial imaging recommendation if a pulsatile mass is found on physical examination?
An ultrasound (USG) of the abdomen is recommended to measure the diameter.
91
What diameter measurement confirms an AAA diagnosis if AAA is suspected?
A diameter greater than 3 cm confirms the AAA diagnosis.
92
What finding indicates SFJ insufficiency and primary varicose veins during assessment?
A dilated saphenous vein with reversed flow indicates SFJ insufficiency and primary varicose veins.
93
What is the recommended treatment for primary varicose veins?
Laser ablation or sclerotherapy is the recommended treatment for primary varicose veins.
94
What interpretation is made for a dilated saphenous vein without reversed flow?
A dilated saphenous vein without reversed flow suggests secondary varicose veins, often with a history of DVT.
95
What is the recommended management for secondary varicose veins?
Conservative management (Mx) is recommended for secondary varicose veins.
96
What is considered the gold standard for varicose vein diagnosis?
Doppler USG is the gold standard for varicose vein diagnosis.
97
What technique is used during Doppler USG to assess for flow reversal in varicose vein assessment?
The Valsalva maneuver is used to check for flow reversal.
98
What does the Valsalva maneuver do in the context of varicose vein assessment?
It increases intra-abdominal pressure, which can reveal flow reversal.
99
What is the reference standard for vascular imaging, although it is invasive?
Digital Subtraction Angiography (DSA) is the reference standard for vascular imaging.
100
What is the normal Renal Artery Doppler RI value?
A normal renal artery Doppler RI value is less than 0.70.
101
What does a renal artery Doppler RI value between 0.70 and 0.80 suggest?
A renal artery Doppler RI value between 0.70 and 0.80 suggests possible moderate stenosis.
102
What does a renal artery Doppler RI value greater than 0.80 indicate?
A renal artery Doppler RI value greater than 0.80 indicates definite high-grade stenosis, greater than 60%.
103
Besides the RI value, what other Doppler finding suggests >60% stenosis in the renal artery?
A Peak Systolic Velocity (PSV) greater than 200 cm/s also suggests >60% stenosis.
104
Where is the Doppler measurement taken for renal artery stenosis assessment?
The Doppler measurement is taken at the renal artery origin, at the level of the aortic bifurcation.
105
What is the meaning of hepatopetal flow in the portal vein?
Hepatopetal flow in the portal vein means normal liver perfusion.
106
What is the normal RI value for the portal vein?
A normal RI value for the portal vein is less than 0.5.
107
What does an elevated RI in the portal vein indicate?
An elevated RI (greater than 0.5) in the portal vein indicates increased vascular resistance and suggests portal hypertension.
108
What does reversed flow (hepatofugal) in the portal vein signify?
Reversed flow (hepatofugal) in the portal vein signifies severe decompensation and carries a poor prognosis with a risk of varices.
109
What is the purpose of Doppler assessment for cirrhosis severity?
Doppler assessment is used as an 'in-course' (IOC) method to evaluate the severity of cirrhosis.
110
What is the primary finding for diagnosing DVT?
Non-compressible vein and absent Doppler flow.
111
What are secondary findings that can support a DVT diagnosis?
Echogenic clot visible in the lumen, absent augmentation, and vein not collapsible with probe pressure.
112
What is the accuracy of Doppler USG for symptomatic DVT?
Greater than 98%.
113
What is the 'Mickey Mouse Sign' observed on Doppler ultrasound?
A cross-section view of the renal artery at its origin, where the aorta appears as a large circle (Mickey's head) and the two renal arteries appear as two small circles (Mickey's ears).
114
What is the clinical use of the Mickey Mouse Sign?
It serves as an anatomical landmark for assessing renal artery stenosis (RAS).
115
What is the 'Target sign' appearance on USG for intussusception?
Concentric rings seen on a transverse view.
116
What is the 'Sandwich sign' appearance on USG for intussusception?
The intussusceptum is seen between adjacent loops on a sagittal view.
117
What is the 'Donut sign' appearance on USG for intussusception?
A donut-like appearance on an axial view.
118
What is the 'Pseudo-kidney sign' appearance on USG for intussusception?
A kidney-like appearance on a longitudinal view.
119
Which sign is considered most specific for intussusception on USG?
The Donut sign.
120
What is the gold standard imaging modality for intussusception?
Ultrasound (USG).
121
What are the advantages of using USG for intussusception diagnosis and management?
It involves no radiation, is diagnostic, and has therapeutic potential with reduction.
122
What is the Doppler indication for leg swelling/pain?
DVT screening
123
What Doppler finding indicates DVT?
Non-compressible vein
124
What is the Doppler indication for leg claudication?
PAD assessment
125
What Doppler waveform suggests severe PAD?
Monophasic waveform
126
What is the Doppler indication for hypertension with a renal bruit?
RAS assessment
127
What Doppler findings suggest Renal Artery Stenosis (RAS)?
RI >0.80, PSV >200
128
What is the Doppler indication for a pulsatile abdominal mass?
AAA assessment
129
What Doppler finding is used for AAA assessment?
Diameter measurement
130
What is the Doppler indication for varicose veins?
Venous insufficiency
131
What Doppler finding suggests venous insufficiency?
Reversed flow with Valsalva
132
What is the Doppler indication for abdominal pain?
Hepatic/portal perfusion
133
What Doppler findings are assessed for hepatic/portal perfusion?
Flow direction + RI
134
What is the Doppler indication for leg swelling in pregnancy?
DVT screening
135
What Doppler findings in a pregnant patient with leg swelling suggest DVT?
Non-compressible + absent flow
136
What is the Doppler indication for GU trauma?
Vascular assessment
137
What Doppler finding is assessed in GU trauma?
Flow patency
138
What Doppler waveform is considered normal for arteries?
Triphasic waveform
139
What Doppler waveform suggests moderate arterial stenosis (40-60%)?
Biphasic waveform
140
What Doppler waveform suggests severe arterial stenosis (>70%)?
Monophasic waveform
141
What is the typical Doppler characteristic of veins?
Monophasic, compressible
142
What is the typical Doppler characteristic of arteries?
Triphasic, non-compressible
143
How is the Resistive Index (RI) calculated?
RI = (PSV - EDV) / PSV
144
What is considered a normal RI?
Normal <0.70
145
What does an RI >0.80 indicate?
RAS (Renal Artery Stenosis)
Radio diagnosis
flashcards
Decks in class (21)
# Cards
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basics and usg abdo184
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usg abdo 2123
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usg abdo 3156
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machines161
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MRI150
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mri and c270
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usg145
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contrast media78
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GI131
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Intestine156
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gallbladder117
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gallbladder 232
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Kidneysss158
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Uretheral trauma ovaries and pregnancy130
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thoracic radio210
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thoracic park 2108
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neuroradio139
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neuroradio 296
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MSK145
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nuclear radio155
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nuclear radio 2119
