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DOI:10.2214/AJR.09.2640
AJR 2009; 193:1446-1451
© American Roentgen Ray Society

Clinical Perspective

Venous Doppler Sonography of the Extremities: A Window to Pathology of the Thorax, Abdomen, and Pelvis

James E. Selis1 and Saumil Kadakia1

1 Both authors: Department of Diagnostic Radiology, Providence Hospital and Medical Centers, 16001 W 9 Mile Rd., Southfield, MI 48075.

Abstract

OBJECTIVE. Swelling of an extremity may be a sign of peripheral deep venous thrombosis but may occasionally be due to more proximal or central venous obstruction. Venous Doppler sonography of the extremities is a commonly performed procedure to evaluate for the presence of deep venous thrombosis. Pulsed-wave Doppler sonography is performed as part of this procedure to evaluate for the presence of cardiac pulsatility or respiratory phasicity. The importance of information provided by the pulsed-wave Doppler waveform must not be undervalued. Thus, the purpose of this article is to discuss the pathology of the thorax, abdomen, and pelvis that can be discovered by identifying abnormal waveforms in the veins of the extremities.

CONCLUSION. Abnormal waveforms provide information for compression or obstruction of the proximal venous system in the thorax, abdomen, and pelvis. When these waveforms are abnormal, previous imaging should be reviewed or additional imaging performed to discover the cause.

Keywords: Doppler sonography • duplex sonography • extremity • phasicity • pulsatility • pulsed-wave sonography • venous sonography


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