Abdominal Vascular Duplex Exams Flashcards

Which Doppler waveform characteristic is most consistent with significant celiac artery stenosis?

Answer: Increased peak systolic velocity with post-stenotic turbulence

Significant celiac artery stenosis produces elevated peak systolic velocity at the stenosis with turbulent, disturbed flow distal to the lesion.

During an abdominal aortic duplex exam, the normal infrarenal aorta diameter in an adult male should be less than:

Answer: 3.0 cm

The normal infrarenal aorta diameter is less than 3.0 cm; a diameter of 3.0 cm or greater defines an abdominal aortic aneurysm.

A patient presents with postprandial abdominal pain and weight loss. Duplex imaging shows elevated PSV in the superior mesenteric artery. Which additional finding would confirm hemodynamically significant SMA stenosis?

Answer: PSV greater than 275 cm/s

A PSV exceeding 275 cm/s in the SMA is the established threshold for hemodynamically significant stenosis (≥70%).

When performing a renal artery duplex exam, the renal-to-aortic ratio (RAR) is calculated using which measurement?

Answer: Renal artery PSV divided by aortic PSV

The RAR is calculated by dividing the highest renal artery PSV by the infrarenal aortic PSV; a ratio ≥3.5 indicates significant stenosis.

In abdominal duplex scanning, the 'median arcuate ligament syndrome' most commonly affects which vessel?

Answer: Celiac artery

The median arcuate ligament of the diaphragm crosses anteriorly and may compress the celiac artery origin, causing extrinsic stenosis.

Which finding on renal duplex ultrasound is most indicative of renal artery occlusion rather than severe stenosis?

Answer: Absence of Doppler signal in the main renal artery with a tardus-parvus waveform in the parenchyma

Occlusion produces no detectable Doppler signal in the main renal artery, while residual parenchymal flow shows a tardus-parvus pattern from collateral supply.

What does a resistive index (RI) greater than 0.80 in the renal parenchymal vessels suggest when evaluating for renovascular hypertension?

Answer: Intrinsic renal parenchymal disease that may limit benefit from revascularization

An RI >0.80 suggests elevated intrinsic renal vascular resistance, indicating parenchymal disease that often predicts poor response to renal artery stenting.