As we continue our efforts to inspire excellence in imaging, this week we will feature another What’s Wrong with this Image blog.  You can check out our previous vascular blogs from this series:

• Carotid Long Axis CCA
• Carotid ICA Prox

As consultants, we review many vascular images, as we help our clients prepare for accreditation.  In the spirit of wanting to help the ultrasound community improve, we think it is beneficial to share some common pitfalls.  We all learn by sharing,not just our knowledge, but our mistakes!

Can you spot what is wrong with this image?

Modality:  Venous Ultrasound

Location:  Right GSV

Answer

This image shows normal flow incorrectly measured as reflux.  Notice the flow that is measured in this image is in the same direction as the normal flow noted before augmentation.  (Both below the baseline)

5 Tips to correctly identifying Venous Reflux

1. Remember reflux occurs when the valves in the veins fail to close properly
2. Reflux occurs when blood flow does not return back to the heart, sits in valve pockets and then begins to travel back down towards the leg
3. This flow of blood, back towards the leg, (instead of towards the heart) is represented by retrograde blood flow on Doppler
4. Reflux may present above or below the baseline depending on the position of the vessel
5. Reflux will ALWAYS be in the opposite direction to the normal flow towards the heart

Venous Reflux Workshop

Join us July 15th, 2017 in Ft. Lauderdale, for our Mastering Venous Reflux workshop!  We are partnering with All About Ultrasound to provide you with a valuable workshop, with everyday tips to incorporate into your scanning practice.  The diagnostic quality of a venous reflux exam is extremely sonographer dependent.  Our goal at this workshop is to provide you with tips and techniques to master this procedure and avoid common pitfalls.

Judith Buckland, MBA, RDCS, FASE

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