Vascular Diagnostics and Imaging

Ultrasound imaging or sonography is a useful way of evaluating the body’s circulatory system. It sends sound waves through the body, which reflect off the internal organs for special instruments to interpret into an image of anatomic parts. No ionizing radiation (x-ray) is involved in ultrasound imaging. Ultrasound images are captured in real-time to help monitor blood flow to organs and tissues throughout the body and evaluate the placement and success of repair, such as after arterial bypass surgery. Ultrasound images can help locate and identify blockages (stenosis) and abnormalities like blood clots, plaque, or emboli.

"Duplex" ultrasounds use two modes of ultrasound simultaneously: a 2-dimensional image of the blood vessel's structure, including the precise location of any problems, and a doppler information showing the velocity and direction of blood flow within the vessel.

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Exams Offered:

Abdominal Aorta Duplex Ultrasound (Abdominal Vascular Ultrasound)

Aortic imaging is a procedure that uses ultrasound technology to examine and evaluate the aorta and screen for many different vascular conditions and disorders, including abdominal aortic aneurysm, endovascular aneurysm repair, and aortic dissection. Aortic imaging is a crucial aspect of diagnosing abdominal aortic aneurysms, as well as blockages.

Please do not eat or drink anything after midnight, the day of your abdominal ultrasound.

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Arterial Doppler (UE/Upper and LE/Lower) Ultrasound 

Arterial doppler ultrasound checks the circulation in either your arms or legs using ultrasound imaging to get an inside look at the arteries by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells.

Arterial Duplex Ultrasound 

Arterial duplex exams are imaging procedures that utilize duplex ultrasonography to detect and monitor disease of the native arteries in the lower and upper extremities and arterial bypass grafts. They can detect stenosis, occlusions, suspected aneurysm/pseudoaneurysm, arteriovenous fistula and fibromuscular dysplasia. During this procedure, color maps the arteries to identify the narrowing of blood vessels.

Carotid Duplex Ultrasound 

Carotid ultrasound examines and evaluates the carotid arteries. This procedure can detect narrowing of the arteries caused by the buildup of plaque, which can lead to carotid artery disease or stroke.

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Hemodialysis Duplex Ultrasound 

This ultrasound test examines the inflow artery, conduit, and venous outflow to identify abnormalities and determine patency and flow adequacy of hemodialysis access, including arteriovenous fistula (AVF) or arteriovenous graft (AVG).

Penile Artery Duplex Ultrasound 

The imbalance of the penile arterial blood inflow and venous blood outflow, and nerve dysfunctions are the leading causes of erectile dysfunction in more than 75% of men. Penile ultrasound and duplex doppler enable the characterization of arterial and venous blood flow in the erect penis and allow for a detailed survey of the corpora cavernosa to identify calcification or scarring inside the erectile tissue of the penis.

The test involves an injection into the base of the penis at the start. During this injection, the substance that opens up the arteries, bringing blood into the erection chambers, is introduced into one of the erection chambers while the ultrasound unit looks at the arteries and veins inside the penis to measure the blood flow in and out of the penis.

Renal Artery Exam and Duplex Ultrasound 

Renal artery ultrasound exams evaluate the size and condition of the renal arteries, checking for narrowing of the renal arteries and blood flow within the kidneys.

Superior Mesenteric/Celiac Duplex 

Mesenteric artery ultrasound imaging examines the mesenteric arteries for stenosis, occlusion, and suspected diseases due to symptoms such as pain after eating (postprandial pain). It can detect the narrowing of the mesenteric arteries.

Temporal Artery Duplex 

High-resolution duplex ultrasound exams offer easy access to the superficial temporal artery to diagnose temporal arteritis and search for any abnormalities such as a halo, stenosis, or occlusion.

Venous Duplex 

To Evaluate for DVT

A venous duplex ultrasound can assess the deep veins of the legs for thrombus (blood clot). A blood clot in the deep venous system of the leg is not dangerous in itself but can become life-threatening if a piece of the blood clot breaks off, travels through the heart into the pulmonary circulation system, and gets lodged in the lung.

For Chronic Venous Insufficiency

A venous duplex ultrasound can assess chronic venous insufficiency (CVI), also called "venous reflux," which occurs when venous valves weaken or malfunction, causing a reversal of blood flow through the valves when a person is standing or sitting. Genetic influences or multiple pregnancies, among other factors, can lead to venous reflux, which causes pain, swelling, edema, skin changes, and ulcerations in the legs.

The ankle brachial index (ABI) is a simple test that compares the blood pressure in the upper and lower limbs during rest – typically the ankle and the arm, through segmental pressures & pulse volume recordings. In some cases, we may ask patients to walk on a treadmill or perform toe raises for a few minutes (exercise) and then repeat the test at both sites. The ABI test helps predict the severity of peripheral arterial disease (PAD). A superior mesenteric drop in ABI with exercise means that a patient might have PAD and a higher risk of heart attack or stroke.

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This diagnostic procedure tests for intermittent perfusion loss, particularly in the arms and hands, for patients with vascular thoracic outlet syndrome (TOS). The examination identifies positions that significantly reduce perfusion to determine if the symptoms originate from a vascular disorder by using doppler, pulse volume recording (PVR) or photoplethysmography (PPG) sensors to detect typical resting waveforms in the digits or hands. Then, the patient performs a sequence of positional maneuvers, including the symptomatic position, to isolate the problem. The examination is typically performed on both the right and left sides in parallel.

Most diagnostic and ultrasound tests take approximately 30-60 minutes. You should wear comfortable, loose-fitting clothing. Insurance plans will typically cover the cost at your negotiated rate, but please check with your insurance provider before your appointment to confirm eligibility.

Noninvasive exams require no preparation on the patient's part and do not involve tools that break the skin or physically enter the body.

LEARN MORE ABOUT VASCULAR STUDIES IN OUR HEALTH LIBRARY