By D.E. Strandness, Jr., MD; Marsha M. Neumyer, BS, RVT, FSVU; Brian L. Thiele, MD
Abdominal vascular sonography is an application in evolution, one made possible by advances in imaging and Doppler technology and by the pioneering clinical work of several groups, including the teams directed by Marsha Neumyer and Brian Thiele at Penn State and the late Gene Strandness at the University of Washington. Technically, abdominal vascular sonography is the most challenging of the vascular applications. The vessels are deeper than those of the neck and extremities and, except for the aorta, rather small. They often travel at awkward angles to the transducer, making it difficult to place a sample volume and obtain reasonably accurate velocity measurements. These and other factors make abdominal vascular sonography highly operator- and volume-dependent and therefore more successful in some hands than others, as reflected in the literature. Here for the first time the acknowledged expertise and long experience of the Vascular Studies Section at Penn State's Milton S. Hershey Medical Center is distilled in a presentation that covers the following:
~ The visceral vascular anatomy.
~ The ultrasonographic appearance of the vascular arteries and veins.
~ The hemodynamics of the visceral vasculature, including the hepatoportal, mesenteric, and renal circulatory systems.
~ The pitfalls of abdominal vascular sonography.
~ The solutions to diagnostic dilemmas.
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