Jon C. Bowersox, MD, PhD, Robert M. Zwolak, MD, PhD, Daniel B

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Presentation transcript:

Duplex ultrasonography in the diagnosis of celiac and mesenteric artery occlusive disease Jon C. Bowersox, MD, PhD, Robert M. Zwolak, MD, PhD, Daniel B. Walsh, MD, Joseph R. Schneider, MD, PhD, Anne Musson, RVT, F.Elizabeth LaBombard, RVT, Jack L. Cronenwett, MD Journal of Vascular Surgery Volume 14, Issue 6, Pages 780-788 (December 1991) DOI: 10.1067/mva.1991.33215 Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 A, Normal fasting triphasic SMA waveform with PSV = 160 cm/sec, EDV = 15 cm/sec. Journal of Vascular Surgery 1991 14, 780-788DOI: (10.1067/mva.1991.33215) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 B, Biphasic SMA waveform in patient with 37% diameter reduction by arteriography. PSV = 210 cm/sec, EDV = 28 cm/sec. Journal of Vascular Surgery 1991 14, 780-788DOI: (10.1067/mva.1991.33215) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 C, Monophasic SMA waveform with aliasing and diffuse spectral broadening in patient with a 94% SMA stenosis. PSV estimated at 235 cm/sec by addition of the aliased peak signal to the truncated base. EDV = 88 cm/sec. Journal of Vascular Surgery 1991 14, 780-788DOI: (10.1067/mva.1991.33215) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 D, Reconstituted SMA waveform beyond a complete occlusion reveals a blunted systolic upstroke and marked turbulence. Velocity was not measurable because of inappropriate angle of insonation. Journal of Vascular Surgery 1991 14, 780-788DOI: (10.1067/mva.1991.33215) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Scatter plots of fasting SMA (PSV, left), and (EDV, right) in 13 normal or minimally stenotic arteries, and 8 severely stenotic (≥50%) arteries. Journal of Vascular Surgery 1991 14, 780-788DOI: (10.1067/mva.1991.33215) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Normal biphasic celiac waveform consistent with low resistance outflow. PSV = 178 cm/sec, EDV = 44 cm/sec. Journal of Vascular Surgery 1991 14, 780-788DOI: (10.1067/mva.1991.33215) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 B, Monophasic celiac waveform with signal aliasing and marked spectral broadening in the presence of a 73% diameter reduction. PSV estimated at 250 cm/sec, EDV = 126 cm/sec. Journal of Vascular Surgery 1991 14, 780-788DOI: (10.1067/mva.1991.33215) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 C, Monophasic celiac waveform with blunted systolic upstroke, spectral broadening and low PSV, felt suspicious for a poststenotic signal. However, no high velocity signal could be identified proximally. Journal of Vascular Surgery 1991 14, 780-788DOI: (10.1067/mva.1991.33215) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions