Peripheral Vascular Ultrasound – How, Why and When (2nd Ed.) – Elsevier Churchill-Livingstone PDF
Preview Peripheral Vascular Ultrasound – How, Why and When (2nd Ed.) – Elsevier Churchill-Livingstone
MEDshare - High Quality Medical Resources - Prelims.qxd 1~9~04 17:01 Page i Peripheral Vascular Ultrasound Prelims.qxd 1~9~04 17:01 Page ii To Wendy, Tony and June For Elsevier: Associate Development Editor:Dinah Thom Development Editor:Kerry McGechie Project Manager:Ailsa Laing Designer: Judith Wright Illustration Manager: Bruce Hogarth Prelims.qxd 1~9~04 17:01 Page iii Peripheral Vascular Ultrasound HOW, WHY AND WHEN SECOND EDITION Abigail Thrush MSc Medical Physicist, Department of Clinical Physics, St Bartholomew’s Hospital, Bart’s and the London NHS Trust, London, UK Timothy Hartshorne Vascular Technologist, Department of Surgery, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK EDINBURGH LONDON NEW YORK OXFORD PHILADELPHIA ST LOUIS SYDNEY TORONTO 2005 Prelims.qxd 1~9~04 17:01 Page iv Disclaimer: Some images in the printed version of this book are not available for inclusion in the eBook. ELSEVIER CHURCHILL LIVINGSTONE © 2005 Elsevier Limited. All rights reserved. The rights of Abigail Thrush and Timothy Hartshorne to be identified as authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP. Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia, USA: phone: ((cid:2)1) 215 238 7869, fax: ((cid:2)1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier homepage (http://www.elsevier.com), by selecting ‘Customer Support’ and then ‘Obtaining Permissions’. First published 1999 Second edition 2005 ISBN 0 443 07283 3 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress. Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the author assumes any liability for any injury and/or damage. The Publisher Printed in China Prelims.qxd 1~9~04 17:01 Page v v Contents Acknowledgments vi 9. Duplex assessment of lower limb arterial Preface vii disease 111 10. Duplex assessment of upper extremity arterial disease 133 1. Introduction 1 2. Ultrasound and imaging 5 11. Duplex assessment of aneurysms 145 3. Doppler ultrasound 23 12. Anatomy of the lower limb venous system and assessment of venous insufficiency 163 4. Creation of a color flow image 35 13. Duplex assessment of deep venous thrombosis 5. Blood flow and its appearance on color flow and upper limb venous disorders 189 imaging 49 6. Factors that influence the Doppler 14. Graft surveillance and preoperative vein spectrum 63 mapping for bypass surgery 207 7. Optimizing the scan 75 Appendix A: Decibel scale 225 Appendix B: Sensitivity and specificity 227 8. Ultrasound assessment of the extracranial cerebral circulation 85 Index 229 Prelims.qxd 1~9~04 17:01 Page vi vvii PERIPHERAL VASCULAR ULTRASOUND Acknowledgments We would like to thank David Evans, Hayley Handford, Pouran Khodabakhsh, Nick London, Salvatore Luca, May Naylor, Ross Naylor, Yvonne Sensier, and Jo Walker for their help and support in the preparation of this book. Prelims.qxd 1~9~04 17:01 Page vii vii Preface Vascular ultrasound is a speciality in its own right sources of errors in any measurements made by and vascular surgeons are becoming increasingly ultrasound should be understood. Specific disorders dependent on the skills of vascular sonographers for of the arterial and venous systems are covered, and the investigation of patients suffering from periph- the techniques for diagnosing these problems are eral vascular disease. This book aims to provide an described. Examples of normal and abnormal understanding of the principles and practice of vas- images and Doppler recordings are included and cular ultrasound. the interpretation of these discussed. British readers An introduction to some of the basic theory please note that the publishers have used American behind the science and technology of ultrasound is spelling in this edition. included. This will help sonographers to understand We hope this book will serve as a useful reference the function of scanner controls and enable them to sonographers new to this field. to obtain optimal images and Doppler recordings. B-mode imaging, color flow and spectral Doppler images are all prone to artefacts, and it is essential London, 2005 Abigail Thrush that their presence be recognized. The potential Leicester, 2005 Timothy Hartshorne This page intentionally left blank Chap-01.qxd 29~8~04 13:19 Page 1 1 1 Chapter Introduction Since the first edition of this book there have been significant developments in ultrasound technology, magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), computed tomo- graphic (CT) scanning and vascular and endovascu- lar surgical procedures. The latest generation of duplex systems produce clearer images, especially with the use of techniques such as harmonic imag- ing and compound imaging. Scanners are more sen- sitive to detecting flow in the arterial and venous systems. The images produced by MRA can be visu- ally stunning, and it has been suggested that MRA and spiral CT may replace duplex investigations in the future. However, duplex scanning still has many advantages. Apart from improvements in image res- olution, it is the ability to visualize flow in real time, make quantitative measurements of blood velocity and detect flow direction that will ensure duplex scanning will remain an important imaging tech- nique for the foreseeable future. Cost and resource implications also are important factors. For instance, it is not cost-effective to screen patients for carotid disease or aortic aneurysm with MRI. However, MRI or CT scanning is essential for planning endo- vascular repair of an aortic aneurysm. Therefore, each modality has its part to play in the management of patients with vascular disorders. In many centers, diagnostic angiography and venography have been largely replaced by the use of duplex ultrasound investigations. This has the advantage of allowing surgeons and physicians to select patients for surgi- cal treatment or conservative management without the need for invasive investigations. In addition, vas- cular radiologists can spend more time performing
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