Vascular Ultrasound: B-Mode, Color Doppler and Duplex Ultrasound, Contrast-Enhanced Ultrasound [Team-IRA] (True PDF)

Vascular Ultrasound
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Contents
Preface
Contributors
Part I Basic Principles
	Chapter 1 Principles of Physics and Technology in Diagnostic Ultrasound
		1.1 Introduction
		1.2 Overview of Ultrasound Techniques
			1.2.1 A-Mode
			1.2.2 B-Mode
			1.2.3 M-Mode
			1.2.4 Color Duplex Sonography (CDS)
			1.2.5 Power Doppler
			1.2.6 Tissue Doppler
			1.2.7 B-Flow
			1.2.8 Color M-Mode
			1.2.9 Doppler Spectral Analysis
			1.2.10 Three-Dimensional Ultrasound Techniques
			1.2.11 (Tissue) Harmonic Imaging
		1.3 General Physical Properties
		1.4 Formation of the Ultrasound Image
			1.4.1 Frame Rate, Pulse Repetition Frequency, Penetration Depth, and Number (Density) of Scan Lines
		1.5 Transducers
			1.5.1 Transducer “Frequency”
		1.6 The Doppler Effect
			1.6.1 Problem of Pulsed Sampling—Aliasing
		1.7 Components of an Ultrasound System
			1.7.1 Interpretation of Color Duplex Images
		1.8 Innovations
			1.8.1 Harmonic Imaging
			1.8.2 Tissue Doppler
			1.8.3 Power Doppler
			1.8.4 Real-Time Compound B-Mode
			1.8.5 Spatial Compound Imaging
			1.8.6 Elastography
			1.8.7 PlaneWave Imaging
		1.9 Documentation
	Chapter 2 Ultrasound Device Settings, Examination Technique, and Artifacts
		2.1 Introduction
			2.1.1 Color Flow Imaging (CFI)
		2.2 Transducer Selection and Instrument Settings
			2.2.1 Prerequisites
			2.2.2 Transducer Selection
			2.2.3 Transducers
			2.2.4 Optimizing the Image with Operator-Controlled Settings
		2.3 Examination Technique, Limitations, and Artifacts
			2.3.1 Examination Protocol
			2.3.2 Limitations and Artifacts
		2.4 Effect of Imaging Technique on Spatial Resolution and Lesion Detectability
	Chapter 3 Hemodynamics
		3.1 Introduction
		3.2 Flow Characteristics in Steady Volume Flow
			3.2.1 Shear Rate
			3.2.2 Flow Resistance, Hagen-Poiseuille Law
			3.2.3 Fahraeus-Lindqvist Effect, Apparent Viscosity, and Axial Migration
		3.3 Flow Characteristics in Straight Vessels of Constant Cross Section
			3.3.1 Reynolds Number as the Determinant of Laminar or Turbulent Flow
		3.4 Flow Characteristics in Vessels of Variable Cross Section
			3.4.1 Bernoulli Principle
			3.4.2 Flow Profile at Constrictions and Expansions
			3.4.3 Flow Separation, Separation Zones, and Turbulent Zones
		3.5 Characteristics of Pulsatile Volume Flow
			3.5.1 Velocity Profile of Pulsatile Flow
			3.5.2 Approach to the Flow Complexity
			3.5.3 Waveforms of Pulsatile Flow/Helical Flow
		3.6 Blood Flow through Stenoses
			3.6.1 Relationship between Vessel Cross Section and Flow Velocity
			3.6.2 Quantification of Stenosis
			3.6.3 Intra- and Poststenotic Flow Changes
			3.6.4 Hemodynamic Significance
		3.7 Evaluation of Stenoses by Color Duplex Imaging
			3.7.1 Criteria for Vascular Findings
			3.7.2 Instrument Settings
			3.7.3 Envelope Curves of Doppler Spectrum
			3.7.4 Spectral Window in Doppler Frequency Analysis
			3.7.5 Timing of Velocity Measurements in Doppler Spectrum
			3.7.6 Angle Correction
			3.7.7 Spectral DopplerWaveform Patterns
			3.7.8 DopplerWaveform Patterns Associated with Stenotic Lesions
			3.7.9 Color Flow Imaging
			3.7.10 Integral Display of Flow Velocity and Volume Flow
			3.7.11 Limitations of Color Duplex Imaging
			3.7.12 Other Techniques
		3.8 Flow Indices
			3.8.1 Analytical Criteria
	Chapter 4 Ultrasound Contrast Agents—Fundamentals and Principles of Use
		4.1 Structure and Properties of Ultrasound Contrast Agents
			4.1.1 Structure
			4.1.2 Pharmacologic Properties of Ultrasound Contrast Agents
			4.1.3 Acoustic Properties of Ultrasound Contrast Agents
		4.2 Equipment and Software: Settings and Transducers
			4.2.1 Quality Aspects of Contrast-Enhanced Imaging
			4.2.2 Transducer Selection
		4.3 Vessel- and Organ-Specific Contrast Doses
			4.3.1 Abdominal and Peripheral Vessels
			4.3.2 Abdominal Organs
			4.3.3 Small Parts
			4.3.4 Intracavitary Use
		4.4 Interpretation of Findings
			4.4.1 Documentation: From JPEG to Digital Raw Data
			4.4.2 Visual Interpretation: Online and Offline
			4.4.3 TIC: Software-Assisted Analysis of Enhancement Kinetics
Part II Vascular Ultrasound
	Chapter 5 Extracranial Cerebral Arteries
		5.1 General Remarks
		5.2 Carotid Artery
			5.2.1 Anatomy, Examination Technique, and Normal Findings
			5.2.2 Stenosis
			5.2.3 Tortuosity and Kinking
			5.2.4 Occlusion
			5.2.5 Special Pathologies
		5.3 Vertebral Artery
			5.3.1 Anatomy, Examination Technique, and Normal Findings
			5.3.2 Stenosis
			5.3.3 Tortuosity and Kinking
			5.3.4 Occlusion
			5.3.5 Subclavian Steal
			5.3.6 Special Pathologies
		5.4 Color Duplex Sonography Compared with Other Modalities
	Chapter 6 Intracerebral Arteries and Brain
		6.1 General Remarks
		6.2 Transtemporal Approach
			6.2.1 Examination Technique and Normal Findings
			6.2.2 Vascular Pathology
			6.2.3 Parenchymal Pathology
		6.3 Transnuchal Approach
			6.3.1 Examination Technique and Normal Findings
			6.3.2 Vascular Pathology
		6.4 Orbital Approach
			6.4.1 Examination Technique and Normal Findings
			6.4.2 Pathologic Findings
	Chapter 7 Limbs
		7.1 Upper Extremities
			7.1.1 Arteries
			7.1.2 Veins of the Neck and Upper Extremities
		7.2 Lower Extremities
			7.2.1 Arteries
			7.2.2 Veins: Superficial Lower Extremity Venous System
			7.2.3 Veins: Deep Venous System
		7.3 Hemodialysis Access
			7.3.1 General Remarks
			7.3.2 Normal Anatomy and Access Types
			7.3.3 Examination Technique and Normal Findings
			7.3.4 Pathologic Findings
			7.3.5 Pre- and Postinterventional Examinations
			7.3.6 Documentation
			7.3.7 Comparison of Color Duplex Sonography with Other Modalities
	Chapter 8 Nonatherosclerotic Arterial Diseases: Vasculitis, Fibromuscular Dysplasia, Cystic Adventitial Disease, Compression Syndromes
		8.1 General Remarks
		8.2 Examination Technique
		8.3 Pathologic Findings
			8.3.1 Vasculitis
			8.3.2 Thromboangiitis obliterans (Winiwarter-Buerger Disease)
			8.3.3 Fibromuscular Dysplasia (FMD)
			8.3.4 Cystic Adventitial Degeneration (CAD)
			8.3.5 Compression Syndromes
		8.4 Documentation
		8.5 Comparison of Color Duplex Sonography with Other Modalities
	Chapter 9 Vascular Malformations
		9.1 General Remarks
		9.2 Etiology and Pathogenesis
		9.3 Differential Diagnosis
		9.4 Classification
		9.5 Pathophysiology
			9.5.1 Truncular Malformations
			9.5.2 Extratruncular Malformations
		9.6 Examination Technique
			9.6.1 Goals
			9.6.2 Necessary Equipment
			9.6.3 Examiner Requirements
			9.6.4 Patient and Examiner Positions
			9.6.5 Examination Protocol
		9.7 Clinical Manifestations and Typical Color Duplex Findings
			9.7.1 Arterial Malformation (AMF)
			9.7.2 Arteriovenous Malformation (AVM)
			9.7.3 Venous Malformation (VMF)
			9.7.4 Lymphatic Malformation (LMF)
			9.7.5 Capillary Malformation (CMF)
			9.7.6 Combined Malformations
		9.8 Documentation
		9.9 Comparison of Color Duplex Sonography with Other Modalities
		9.10 Conclusion
Part III Abdominal Organs: Vascularization and Perfusion
	Chapter 10 Aorta and Outgoing Branches
		10.1 General Remarks
			10.1.1 Color Duplex Sonography (CDS)
		10.2 Aortic Anatomy and Variants
			10.2.1 Vascular Branches
			10.2.2 Anatomical Variants
		10.3 Examination Technique
			10.3.1 Transducer and Device Settings
			10.3.2 Color Duplex Sonography of the Aorta
			10.3.3 Color Duplex Sonography of the Aortic Branching Vessels
			10.3.4 Contrast-Enhanced Ultrasound (CEUS)
		10.4 Normal Findings
			10.4.1 Abdominal Aorta
		10.5 Pathologic Findings in the CCDS
			10.5.1 Wall Thickenings, Plaques, Stenoses, and Occlusions
			10.5.2 Aneurysms
			10.5.3 Aneurysm Verum
			10.5.4 Aortic Dissection
			10.5.5 Inflammatory Aneurysm
			10.5.6 Infected or Mycotic Aneurysm
			10.5.7 Complications
		10.6 Pre- and Postinterventional Diagnostics
			10.6.1 Pre- and Postsurgical Examinations
			10.6.2 Pre- and Postinterventional Examinations
			10.6.3 Examination Technique
			10.6.4 Procedure in Case of Endoleaks
			10.6.5 Findings
			10.6.6 Definition and Classification of Endoleaks
			10.6.7 Long-Term Follow-up
			10.6.8 Image Fusion for the Localization and Characterization of Endoleaks and for Further Intervention Monitoring
		10.7 Documentation
		10.8 Value of Color Duplex Sonography in Comparison to Other Imaging Methods
			10.8.1 Computed Tomography
			10.8.2 Magnetic Resonance Angiography
			10.8.3 Importance of Color Duplex Sonography and CEUS
	Chapter 11 Visceral Arteries
		11.1 General Remarks
		11.2 Anatomy, Variants, and Collaterals
			11.2.1 Celiac Trunk and Its Branches
			11.2.2 Superior and Inferior Mesenteric Arteries
			11.2.3 Preformed Arterial Collaterals
		11.3 Examination Technique
			11.3.1 Settings
			11.3.2 Patient Preparations
			11.3.3 Color Duplex Sonography
			11.3.4 Examination Time
			11.3.5 Contrast-Enhanced Ultrasound
		11.4 Normal Findings and Variants
			11.4.1 Normal Findings
			11.4.2 Variants
		11.5 Pathologic Findings
			11.5.1 Plaque, Stenosis, and Occlusion
			11.5.2 Acute Intestinal Ischemia: Embolism, Thrombosis, Dissection, and Nonocclusive Intestinal Ischemia
			11.5.3 Aneurysms
			11.5.4 Arteriovenous Malformation
			11.5.5 Involvement of Visceral Vessels by Systemic and Inflammatory Diseases
			11.5.6 Chronic Inflammatory Bowel Disease
			11.5.7 Applications in Vascular Surgery and Interventional Radiology
			11.5.8 Follow-up after Organ Transplantation
		11.6 Documentation
		11.7 Comparison of Color Duplex Sonography with Other Modalities
			11.7.1 Angiography
			11.7.2 Sonography
			11.7.3 Computed Tomography
			11.7.4 Magnetic Resonance Angiography
		11.8 Importance of CDS and CEUS in Clinical Diagnosis
			11.8.1 Aneurysms and Arteriovenous Malformations
			11.8.2 Stenoses and Occlusions
			11.8.3 Follow-Up
			11.8.4 Quantitative Measurements
	Chapter 12 Abdominal Veins
		12.1 General Remarks
		12.2 Anatomy, Variants, and Collaterals
			12.2.1 Inferior Vena Cava, Lumbar and Pelvic Veins
			12.2.2 Renal Veins
			12.2.3 Gonadal Veins
			12.2.4 Portal Venous System and Mesenteric Venous System
		12.3 Examination Technique
			12.3.1 Transducer
			12.3.2 Protocol
			12.3.3 Velocity Measurements
		12.4 Normal Findings
			12.4.1 Inferior Vena Cava, Lumbar and Iliac Veins
			12.4.2 Renal Veins
			12.4.3 Hepatic Veins
			12.4.4 Portal and Mesenteric Venous System
		12.5 Pathologic Findings
			12.5.1 Malformations
			12.5.2 Thrombosis, Stenosis, and Occlusion
		12.6 Applications of CDS in Surgical and Interventional Procedures
			12.6.1 Vena Cava Filter Placement
			12.6.2 Extracorporeal Membrane Oxygenation (ECMO)
			12.6.3 Reconstructive Surgery of Cardiac Anomalies
		12.7 Documentation
		12.8 Comparison of Color Duplex Sonography with Other Modalities
			12.8.1 Inferior Vena Cava and the Renal, Iliac, and Ovarian Veins
			12.8.2 Mesenteric and Splenoportal Axis
	Chapter 13 Microcirculation and Tumor Perfusion
		13.1 General Remarks
		13.2 Available Imaging Techniques
		13.3 Tumor Vasculature and Perfusion
	Chapter 14 Kidneys and Renal Transplants
		14.1 General Remarks
		14.2 Anatomy and Variants
			14.2.1 Orthotopic Kidneys
			14.2.2 Variants
		14.3 Examination Technique
			14.3.1 Procedure
		14.4 Normal Findings
			14.4.1 Extrarenal Arteries
			14.4.2 Intrarenal Arteries
		14.5 Pathologic Findings
			14.5.1 Nephrolithiasis and Urolithiasis
			14.5.2 Inflammatory Renal Diseases
			14.5.3 Tumors and Tumor Vascularity
			14.5.4 Primary Vascular Diseases of the Kidney
			14.5.5 Acute Renal Failure
			14.5.6 Renal Trauma
		14.6 Evaluation of Renal Transplants
			14.6.1 Protocol for Ultrasound Evaluation of Renal Transplants
			14.6.2 Complications of Renal Transplantation in Clinical Ultrasound
			14.6.3 Outlook
		14.7 Documentation
		14.8 Comparison of Color Duplex Sonography and Contrast-Enhanced Ultrasound
	Chapter 15 Liver and Portal Venous System
		15.1 General Remarks
		15.2 Anatomy and Common Variants
			15.2.1 Oxygen and Nutrient Supply of the Liver
			15.2.2 Arterial Blood Supply
			15.2.3 Portal Vein
			15.2.4 Intrahepatic Vascular Distribution and the Hepatic Segments
		15.3 Examination Technique Including Contrast Administration
			15.3.1 Examination Protocol and Doppler Measurements
			15.3.2 Equipment Settings and Flow Detection Techniques
			15.3.3 Contrast Examination
		15.4 Normal Findings, Variants, and Hemodynamics
			15.4.1 Hemodynamics
		15.5 Pathologic Findings
			15.5.1 Aneurysms
			15.5.2 Malformations of the Portal Venous System
			15.5.3 Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu Disease)
			15.5.4 Obstruction of the Hepatic Veins
			15.5.5 Circumscribed Hepatic Vein Stenosis
			15.5.6 Thrombosis of the Splenoportal Axis, Portal Vein Thrombosis
			15.5.7 Diffuse Liver Diseases
			15.5.8 Portal Hypertension
			15.5.9 Benign Focal Hepatic Lesions
			15.5.10 Focal Hepatic Malignancies
			15.5.11 Liver Transplantation
			15.5.12 Shunt Procedures
			15.5.13 Cancer Therapy
		15.6 Diagnosis in Surgical and Interventional Percutaneous Procedures
		15.7 Comparison of Color Duplex Sonography and CEUS with Other Modalities
			15.7.1 Primary Vascular Diseases of the Liver
			15.7.2 Secondary Vascular Changes in Diffuse Liver Diseases
			15.7.3 Focal Hepatic Lesions
		15.8 Conclusion
	Chapter 16 Contrast-Enhanced Ultrasound (CEUS) in Biliary Diseases
		16.1 Background
		16.2 Examination Technique
		16.3 Pathologic Findings
			16.3.1 Cholecystitis and Cholangitis
			16.3.2 Tumors of the Gallbladder Wall
	Chapter 17 Contrast-Enhanced Ultrasound (CEUS) in Intestinal Diseases
		17.1 General Remarks
		17.2 Examination Technique
		17.3 Pathologic Findings
			17.3.1 Diverticulitis
			17.3.2 Inflammatory Bowel Disease
			17.3.3 Ischemia and Infarction
			17.3.4 Intestinal Tumors
	Chapter 18 Contrast-Enhanced Ultrasound (CEUS) in Pancreatic Diseases
		18.1 General Remarks
		18.2 Examination Technique
		18.3 Acute Pancreatitis
		18.4 Pancreatic Masses
			18.4.1 Solid Pancreatic Tumors
			18.4.2 Cystic Pancreatic Lesions
	Chapter 19 Contrast-Enhanced Ultrasound (CEUS) in Splenic Diseases
		19.1 General Remarks
		19.2 Examination Technique, Normal Findings, and Indications for CEUS
		19.3 Pathologic Findings
			19.3.1 Benign Solid Lesions
			19.3.2 Malignant Lesions
			19.3.3 Splenic Infarction and Bleeding
	Chapter 20 Contrast-Enhanced Ultrasound (CEUS) in Pediatric Diseases
		20.1 General Remarks
		20.2 Contrast-Enhanced Ultrasound (CEUS) in Children
			20.2.1 Voiding Urosonography (VUS) Using Ultrasound Contrast Agents (US-CA)
			20.2.2 Potential Indications for Intravenous Use of CEUS in Children
			20.2.3 Indications for Contrast-Enhanced Ultrasound (CEUS) in Children
		20.3 Technical Aspects and Practical Approach
		20.4 Dosage of the Ultrasound Contrast Media
		20.5 Safety, Side Effects, and Contraindications
		20.6 Limitations
	Chapter 21 Novel and Upcoming Ultrasound Techniques
		21.1 B-Flow and B-Flow CEUS
		21.2 Superb Microvascular Imaging (SMI)
		21.3 PlaneWave Imaging, Ultrafast Doppler, Vector Flow Imaging (VFI)
		21.4 Novel Calculation Techniques for Arterial Stiffness
		21.5 Novel Ultrasound Contrast Agents
		21.6 Novel Dynamic B-Mode Techniques to Evaluate Arterial Stiffness
		21.7 Fusion Imaging
Index
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