Case of the month - April

Colour Duplex Ultrasound combined with 3D Tomographic Ultrasound as a potential sole imaging modality prior to lower limb arterial reconstruction

Authors:

Dr Cleona Gray PhD Chief Vascular Physiologist, Mater Misericordiae University Hospital, Dublin 7
Mr Edward Mulkern PhD FRCSEd, Consultant Vascular Surgeon, Mater Misericordiae University Hospital, Dublin 7

Introduction

The limitations and complications associated with conventional angiography (CA) and MR Angiography (MRA) prior to lower limb revascularization have led to an increased need for a suitable alternative imaging modality. Colour Duplex Ultrasound (CDU) with 3D Tomographic Ultrasound may be an appropriate alternative modality. In patients with limb ischemia a well-performed CDU offers several advantages over traditionally used imaging modalities. CDU is noninvasive and does not require the use of nephrotoxic agents.  It is readily available with color flow and waveform analysis providing a better estimation of the hemodynamic significance of disease unlike MR angiography which risks overestimation of disease. It allows visualization of the entire artery and not only of the lumen of the vessel, enabling plaque characterization.  Unlike conventional Angiography Color flow and power Doppler techniques have the ability to identify patent native arteries subjected to chronic disease with low flow states. CDU with 3D Tomographic Ultrasound performed by a skilled Vascular Physiologist may represent an alternative to conventional angiography for patients with lower limb ischemia.

 

What you gain from PIUR tUS

Reduced risk

Minimise exposure to ionizing radiation and nephrotoxic contrast by reducing the need for CT and catheter angiography

Higher return on investment

Replace high-cost diagnostic imaging technologies for many indications and keep your CT and MRI instruments free for other patients

Optimised workflows

Acquire all relevant diagnostic information with one examination and facilitate one-stop outpatient clinic appointments to include consultation and investigation

Shorter examination times

Speed up your ultrasound examinations through three-dimensional data analysis

Improved communication & data exchange

Share complete ultrasound volume data with surgeons and let them see for themselves what they are going to operate on

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