Duplex Imaging-Arterial LE
By
Laurie Bentson MHA, RVT, RDMS
Learning Objective
• Review etiology and mechanism of LE arterial disease
• Discuss anatomy
• Discuss duplex imaging technique
• Review diagnostic criteria
• Discuss normal ultrasound findings
• Discuss abnormal ultrasound findings
• Discuss common pathological conditions encountered in LE arterial
duplex imaging
• Apply knowledge-case studies
Duplex Imaging- Arterial LE
Etiology for arterial disease: Atherosclerosis-most
common at 90%
• Process involving accumulation of fatty
substances in regions of intima in medium
and large arteries
• Disease can be focal or diffuse at any
level or multiple levels of the arterial
system
• Occurs primarily in regions where the
endothelial cells are dysfunctional due
to shear stress exposure on wall of
artery
• Outer wall of bifurcations
• Inner wall of curves arteries
• Origin or ostia
• Distal SFA
• Popliteal can calf arteries
Duplex Imaging-Arterial LE
Mechanism of Disease
Atherosclerosis
• Most common arterial disease (ALL
arteries!)
• Forms in the arterial wall and decreases
flow with lumen narrowing (stenosis) or
completely obstructs flow (occlusion)
• Significant obstruction changing flow
dynamics is considered
hemodynamically significant –
Typically 50% diameter reduction
and >60% stenosis per velocities
• Chronic progressive disease
• Occurs at bifurcation points
• Ultrasound imaging characterizes plaque
Duplex Imaging-Arterial LE
Mechanism of Disease
Emboli: Typically, a piece of plaque
or thrombus that moves from a
proximal point and travels distally
through larger arteries that become
smaller. Eventually embolus
obstructs vessel as artery becomes
smaller and embolus is larger than
vessel