This identification occurs visually, or in the absence of wall-to-wall compression. Note the lack of compressibility of surrounding veins indicating thrombus extends within them | Back to top What’s normal or not?Ī ‘normal’ scan in this context does not mean the exclusion of a DVT, as this is a rule-in process alone.Ĭlear identification of the common femoral vein, down to the distal femoral vein and popliteal vein, with normal wall-to-wall compression is ‘normal’ in this context. A positive scan in this context identifies the presence of thrombotic material within the examined vessel. Video 5: popliteal vein normal compression and with DVT. The sapheno-femoral junction is therefore the attachment point of the corresponding ear, to the face of Mickey Mouse (Figure 1). The orientation of the ‘ear’ vessels depends on which leg is being scanned. The face of Mickey Mouse represents the common femoral vein (CFV), while the ears represent the common femoral artery (CFA) and the long saphenous vein (LSV). The Mickey Mouse sign represents the level (in transverse plane) at which the common femoral vein and the sapheno-femoral junction are visible. Once you have positioned the patient comfortably so they are exposed from groin to knee, the first landmark to find is the ‘Mickey Mouse sign’. The minimum dataset detailing the images in the three part rule-in DVT scan can be found here. The anatomy of interest is the area from the common femoral vein (CFV) down to the distal popliteal vein (trifurcation). During the FAMUS scanning process, the common femoral vein, femoral vein, profunda vein and the popliteal vein are visualised. For larger legs requiring higher depths, the curvilinear (e.g abdominal) transducer which has lower frequency is more appropriate. The vascular probe with a linear transducer has a high frequency and is useful for high resolution assessment of small legs where low depths are anticipated. High frequency probes however have lower penetration in general, probes of over 3MHz would suffice. This however is not a rule-out departmental scan.įor the assessment of DVT, a Brightness (B) mode ultrasound machine is needed. The probes needed for good vascular assessment need to of high frequency. In FAMUS, we have adopted a systematic rule-in scanning protocol that aids management (identifies significant clot load) at that critical time point in the patient’s care. There is now mounting evidence 1, 2, 3 that is supportive of rule-in scans that help answer this critical question. As part of the assessment of the sick or suspected VTE patient, early indication of a significant clot burden is important for the tailoring of management and overall care of the patient. This requires a formal, complete proximal vein assessment with ultrasound. The 2012 NICE guidance on VTE recommends proximal leg vein ultrasound scanning as the diagnostic endpoint in DVT investigations. Equipment | Anatomy | Scanning process | What’s normal or not?
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |