Venous Doppler Remains primary modality for assessing deep venous thrombosis of upper & lower extremities Diagnostic Criteria for DVT: Most reliable is loss of normal vein compressibility Duplex or color Doppler used to document flow Echogenic material in venous lumen is most specific sign of DVT but is only 50% sensitive

Acute Appendicitis Look for blind ending noncompressible tubular structure arising from cecum Diameter > 6mm in adult suspicious Appendicolith in appropriate clinical setting is suspicious

Venous Doppler  Finding - Acute occlusive DVT of popliteal vein into trifurcation

Venous Doppler  Finding - echogenic non occlusive chord consistent with chronic DVT.

Arterial Doppler  Evaluate Carotid disease  Screen for or monitor AAA  Evaluate peripheral vascular disease  Intracranial doppler in Sickle Cell Dz and subarachnoid hemorrhage

Carotid Stenosis S&W Lab Criteria % STENOSISVELOCITY (METERS/SEC) IC/CC PEAK SYSTOLIC RATIO 0-49<1.3< < < >2.1>3.1 OccludedNo flow

Carotid Arterial Evaluation  Finding - High Grade Stenosis – Proximal ICA with elevated peak systolic velocity

Carotid Arterial Evaluation  Finding – absence of flow consistent with occluded CCA

Screening for AAA  Sonography can define aortic size, determine the extent of atherosclerosis, and detect aorta dissection