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Sonography
Vascular Sonography
| Term | Definition |
|---|---|
| What is the most common form of systemic inflammatory vasculitis in adults | GCA Giant cell Arteritis or Temporal Arteritis |
| what gender is GCA most common in | most common in women |
| What can Temporal Arteritis lead to | Can lead to blindness when left untreated |
| What is the gold standard in GCA | Biopsy |
| what appears arounf the lumen of the temporal artery? | Hypoechoic ring areas. Often detected in one or more sites unilaterally or bilaterally defined as halos |
| Halos | hopoechoic ring areas |
| how is diagnosis of arteritis made? | Velocity Changes Measure before the narrowed area and in the narrowed area as well as distal to the area |
| If the velocity ______ or ______ then it is considered positive | Increases or doubles |
| how will the vessel present in transverse? | vessel will also show thickened, irregular intimal lining and in the transverse plane there will be a halo appearance around the vessel. |
| what is the general course of treatment ? | steroids and its very effective |
| arteriogram | radiographic visualization of the arteries. |
| venogram | radiographic visualization of the veins. |
| angiogram | generalized for imaging of vessels. |
| what are other forms of vascular testing? | MRA CTA and angiogram |
| what is considered the gold standard of vascular testing? | Angiography |
| T or F venogram is always done to visualize suspected abnormalities in any portion of the cardiovascular system. | false its angiography |
| what are the common catherization sites | Carotid artery, subclavian artery, brachial artery/vein and femoral artery/vein |
| risks of using iodinated contrast in angiography and CTA | Allergic reaction, anaphalxsis, renal failure, pseudoaneurysm, stroke, embolus, hematoma, fistula pulmonary edema |
| lab values should be measured before contrast can be administered for CTA, MRA or Angiography | renal function |
| how is the Contrast used for MRA, CTA and angiography excreted | through the kidneys |
| CTA and MRA are good exams but not _______________ procedures can be performed unlike with angiography, intervention can be performed during the exam. | interventional |
| what is CTA limited in | is limited by bone and metal and it does use ionizing radiation. |
| CTA advantage over MRA and angiography | is quicker and less expensive |
| MRA advantage over CTA and angiography | no ionizing radiation and contrast |
| MRA limitations | Claustaphobic patients, patients with reduced renal function, long exam, cannot be done within 6-8 weeks of stent placement, table weight limits, some pacemaker/ defibrillator, aneurysm clips are not allowed in MRI, some IUDs, etc |
| MRA CAN _________________ STENOSIS, due to slow flow or turbulence | OVERESTIMATE |
| interventional procedures that can be done | Stent placement, angioplasty, coil placement |
| what uses diameter reduction in the analysis of disease | angiography. When surgical intervention in required a bypass or endarterectomy may be done. |
| NASCET | North American Symptomatic Carotid Endarterectomy Trial |
| NASCET states that : | North American Symptomatic Carotid Endarterectomy Trial (NASCET) demonstrated a highly beneficial effect of carotid endarterectomy in patients with angiographically confirmed high-grade carotid stenosis (70% to 99%)._ |
| true or false: This is an anatomical study- not functional | true |
| what should be controlled to avoid a pseudoaneurysm | puncture site |
| what should we look for? | filling defects- Looking for lumen reduction or expansion. This may be intrinsic from plaque or extrinsic from tumors or compression or aneurysm. |
| NASCET equation | B-A/B x100 |
| Pseudoaneurysms | are false aneurysms that occur at the site of arterial injury. Typically only the adventitia will encapsulate them. |
| what is the most common complication after a femoral access angiography procedure | pseudoaneurysms |
| what can occurs after an ABG, fistula access attempt and trauma. | pseudoaneurysms |
| what needs to be identified in a pseudoaneurysm | neck must be identified and the flow should be Dopplered. The flow pattern that will present is called a to-fro pattern. |
| to-fro pattern | flow pattern present in neck of pseudoaneurysm |
| A method of opening a partially blocked or stenotic vessel by using angiography to guide the tool to the area of stenosis and then a balloon is deployed to open the vessel. The balloon is deflated and then removed. | angioplasty or balloon angioplasty |
| Angioplasty-percutaneous transluminal coronary angioplasty-PTCA | Angioplasty using a balloon to open up the vessel and then a stent placed in the area. |
| reason to use Ultrasound contrast | Enhance regular ultrasound images or vessel identification Vessel status, patency, stenosis etc Evaluate flow to an organ or tumor or to infection or in the urinary system such as the urinary bladder for reflux |
| What does off-label mean? | Using a substance for something other than approved for, or normally used for. |
| 4 advantages of US contrast | Safe Accurate More affordable than CTA/MRA Easy |
| what is first generation ultrasound contrast? | agitated saline bubbles used in the right-side heart studies. It does well to visualize the right side of the heart |
| in first generation ultrasound do the bubbles survive? | The bubbles will not survive through the lungs so pathology visualized with this method is most commonly a PFO- patent foramen ovale. |
| Second generation contrast is | microbubbles of gas surrounded by a phospholipid membrane. |
| which generation contrast survive the lungs | 2nd generation will survive the lungs and will perfuse from venous injection through to the arterial side for perfusion of masses and organs, lumen size (reduction/stenosis, or aneurysm). |
| what principles does ultrasound contrast use? | Ultrasound contrast uses some of the principles of harmonic imaging |
| what does it mean that ultrasound contrast uses the principles of harmonic imaging ? | This is the production of stronger signals sent back than what was sent out by combining the signals. |
| Ultrasound contrast uses the principles of scatter ccurring of the sound waves because | because of non-linear behavior. |
| why do we use a power setting with a low mechanical index of contrast? | because any setting too high will destroy the bubbles. |
| The use of ultrasound contrast could provide an alternative for | CT and MRI in the cases of patients with renal failure. |
| what do you use to calculate the ICA/CCA ratio? | Highest ICA/ distal CCA for ratio |
| what is the percentage stenosis if the PSV is ,125 cm/sec and EDV is n/a ? | Less than 50% or normal |
| what is the percentage stenosis if the PSV and EDV is absent | occluded |
| what is the percentage stenosis if the PSV is >125 cm/sec and EDV >140 cm/sec? | 80-99% stenosis |
| what is the percentage stenosis if the PSV is >125cm/sec and EDV <140 cm/sec? | 50-79% stenosis |
Created by:
jcazares10
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