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US DVT

LOWER EXTREMITY DVT

  • Use the 9L linear transducer (5L in groin if big patient)
  • Use the LEV preset settings on the GE machine
  • PROTOCOL
    • EIV
      • Longitudinal grayscale
      • Longitudinal color flow
      • Longitudinal Doppler (get respiratory phasicity)
    • CFV/GSV (“Mickey mouse” )
      • Transverse with compression
      • "Mickey mouse"
        • Medial ear = saphenous vein/saphenofemoral confluence
        • Face = CFV
        • Lateral ear = SFA

    • BONUS POINTS FOR BIFURCATION
      • Longitudinal bifurcation of CFV into: 
        • Deep FV (profunda) 
        • FV (superficial)  
    • Femoral vein (FV), aka superficial FV
      • Proximal FV: Transverse with compression
      • Mid FV: Transverse with compression
      • Distal FV: Transverse with compression (if can't get compression, get color)
    • Popliteal Vein
      • Transverse with compression
      • Longitudinal grayscale
      • Longitudinal color flow
      • Longitudinal doppler + augmentation
    • Check popliteal fossa for Baker's cysts  
    • BONUS points for calf veins


UPPER EXTREMITY DVT

  • Spontaneous DVT is uncommon
  • More common from a central chest lesion, so check CXR first!
  • CT better for central veins (can’t see beyond clavicle)
  • Use L7 probe
  • Start at AC fossa to find pair of brachial veins next to artery
  • Protocol  
    • IJV
      • Longitudinal color flow
      • Transverse with compression 
    • IJV/subclavian vein confluence
      • Longitudinal color flow
    • Subclavian vein (can't compress)
      • Longitudinal waveform
      • Contralateral subclavian vein longitudinal waveform
    • Axillary vein (place patient's arm over head)
      • Longitudinal color flow
      • Transverse with compression
    • Brachial vein
      • Transverse with compression
    • Cephalic vein
      • Transverse with compression
    • Basilic vein
      • Transverse with compression






Ċ
RadRez Administrator,
Jul 9, 2013, 2:21 PM
Ċ
RadRez Administrator,
Jul 9, 2013, 2:26 PM