Replies to This Discussion

Permalink Reply by Syed Amir Gilani on January 30, 2011 at 10:12am

http://pediatrics.aappublications.org/cgi/content/full/118/5/1999

http://www.iowaradiology.com/quickguide/US_Limited_Doppler_Ultrasou...

Permalink Reply by Darla J Matthew on March 2, 2011 at 7:53pm

The SMA should demonstrate a high resistance spectral Doppler display in a fasting patient. In a normal patient the diastolic flow in the SMA should increase (lower resistance) after the patient eats due to the increased demand for blood from the intestines.

Permalink Reply by Jessica J Budd, RDMS on May 22, 2011 at 11:02pm

Does anyone have any scanning tips or techniques they use when performing SMA Doppler?

Permalink Reply by Syed Amir Gilani on September 16, 2011 at 10:44am

 MESENTERIC DOPPLER SONOGRAM

Recommended Transducer(s): GE 700: 3.5 curved linear probe Acuson Sequoia: 4Cl or 4Vl  GE Logiq: 3.5 curved, 4 sector  The patient should be NPO at least 8 hours prior to exam. Post-prandial imaging is not necessary.  Images: Follow RUQ (“Limited”) ABDOMINAL SONOGRAM and add the following: Color Doppler:   ƒ Sagittal aorta including Celiac and SMA origins. ƒ Transverse Celiac origin. Spectral Doppler: ƒ At least 3 waveforms each of the celiac and SMA within 3 cm. of origins. ƒ Measure PSV and EDV for each ƒ Common hepatic artery waveform (just past splenic artery take-off). ƒ If SMA is non-turbulent / biphasic (normal is triphasic), look for replaced right hepatic artery off SMA (right lateral aspect of SMA going toward liver).  Criteria for mesenteric artery stenosis: Celiac:  ƒ PSV > or equal to 200 cm/sec ƒ No flow  ƒ EDV > or equal to 55 cm/sec = 70% stenosis = occluded = > or equal to 50% stenosis SMA:  ƒ PSV > or equal to 275 cm/sec ƒ No Flow  ƒ EDV > or equal to 45 cm/sec  = > or equal to 70% stenosis = occluded = > or equal to 50% stenosis (may be elevated if replaced right hepatic artery, in which case SMA waveform will be low resistance biphasic). CHA:   ƒ Retrograde flow  = severe celiac artery stenosis/ occlusion Duplex-Doppler ultrasound diagnosis of high-grade SMA/celiac artery stenosis / occlusion does NQI necessarily mean the patient has chronic mesenteric ischemia --it remains a clinical diagnosis.