Ultrasound in Abdominal Aorta and Peripheral Arteries: How To Do It and Normal Findings

Abdominal aortic ultrasound is performed with the patient in a supine position, preferably after 8 to 12 hours of fasting.

The images are obtained with a 3-5 MHz convex transducer in longitudinal and transverse planes from the level of the diaphragm to the bifurcation. The diameter is recorded at the proximal, mid, and distal aorta.

Sonographically the normal aorta has an anechoic lumen, echogenic walls and a laminar flow. The waveform shape is characterized as high resistance.

Iliac arteries are performed with a 3-5 MHz convex transducer: the entire length should be examined, but its tortuosity or bowel gas can obscure the vessels.

Peripheral arterial sonography should be performed with a 7.5-10 MHz linear array transducer, or a 3-5 MHz convex transducer, equipped with pulsed Doppler and color Doppler capability.

Normal peripheral arteries have a triphasic high resistance flow waveform: forward flow during systole, reversed flow in early diastole and forward flow again (due to the elastic recoil of vessel walls). 

In this lesson the basic methodology of the echocolor Doppler study of the abdominal aorta, iliac and peripheral arteries is presented.

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