Introduction to Vascular Ultrasonography

649 Pages·2012·121.346 MB·English

by  John Pellerito, Joseph F Polak

6th
Edition
Introduction to
Vascular
Ultrasonography
John S. Pellerito, MD, FACR, FSRU, FAIUM
Associate Professor of Radiology
Hofstra North Shore-LIJ School of Medicine;
Associate Chairman
Department of Radiology
Chief, Division of Ultrasound, CT, and MRI
Director, Peripheral Vascular Laboratory
North Shore University Hospital
Manhasset, New York
Joseph F. Polak, MD, MPH
Professor of Radiology
Tufts University School of Medicine;
Vice Chair of Business Development
Tufts Medical Center
Boston, Massachusetts;
Chief of Radiology
Lemuel Shattuck Hospital
Jamaica Plain, Massachusetts
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
INTRODUCTION TO VASCULAR ULTRASONOGRAPHY ISBN: 978-1-4377-1417-3
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Library of Congress Cataloging-in-Publication Data
Introduction to vascular ultrasonography -- 6th ed. / [edited by] John S. Pellerito, Joseph F. Polak.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4377-1417-3 (hardcover : alk. paper)
I. Pellerito, John S. II. Polak, Joseph F.
[DNLM: 1. Vascular Diseases--ultrasonography. 2. Blood Vessels--ultrasonography. WG 500]
LC classification not assigned
616.1’307543--dc23 2012006759
Content Strategist: Pamela Hetherington
Content Development Specialist: Joanie Milnes
Publishing Services Manager: Anne Altepeter
Senior Project Manager: Cheryl A. Abbott
Design Direction: Ellen Zanolle
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
To Elizabeth, John, Alana, and Daniel for your support and encouragement.
To Marie and Peter for being there for me from day one. And to my
colleagues and sonographers for making work fun.
J.S.P.
To Jo-Anne and Alexandra.
J.F. P.
ACKNOWLEDGMENTS
I gratefully acknowledge the following individu- I gratefully acknowledge all of the individuals
als who have contributed to this sixth edition. who have contributed to this sixth edition.
My co-editor, Joseph Polak, for his insights, My greatest thanks go to my co-editor, John
expertise, and humor throughout the writing and Pellerito, for sharing his knowledge and opti-
editorial process. mism throughout the writing and editorial pro-
All the authors who contributed their time, cess. I especially thank him for taking me on as
energy, and outstanding chapters. his co-editor for this truly unique textbook of
My administrative assistant, Barbara Stanco, vascular ultrasound.
for her patience and support. I would like to recognize the efforts of all of the
My co-workers in the Peripheral Vascu- chapter authors and co-authors who have spent
lar Laboratory, James Naidich, MD; Catherine so much of their precious time preparing their
D’Agostino, MD; Brian Burke, MD; Danielle chapters, especially colleagues who have shared
Berne, RN; Bindu Rameshan, RVT; Jane Joo Ah their knowledge when participating at various
Kim, RVT; John Torres, RVT; Glenn Prucha; Dan- continuing medical education venues, primar-
iel Hernandez, RVT; and Christine Antoldi. ily the long running Current Practice in Vascu-
My chief technologists, Amalia Pose and lar Ultrasound (www.IAME.com), the AIUM
Saiedeh “Nanaz” Maghool and all of the sono- (www.AIUM.org), the RSNA (www.RSNA.org),
graphers at North Shore for their commitment to and the ACR (www.ACR.org).
excellence. I give my special thanks and gratitude to the
Joanie Milnes, Pamela Hetherington, Cheryl sonographers who have contributed materials
Abbott, Rebecca Gaertner, and all at Elsevier for to this book: Jean M. Alessi-Chinetti, Gregory Y.
their help and expertise. Curto, and Richard J. Porter.
Irwin Kuperberg and everyone at IAME for I thank all of the staff of Elsevier who had to put
their dedication to medical education and their up with my sometimes finicky requests in order to
support of vascular ultrasound. prepare an improved edition of this book.
And always, my family, Elizabeth, John, Alana, I especially thank my wife, Jo-Anne, and daugh-
Daniel, Peter, Mom, and Dad, for their continu- ter, Alexandra, for putting up with my work habits
ing support and understanding. and for my takeover of our living room to accom-
modate my workstation and its’ 30-inch screen.
John S. Pellerito, MD, FACR, FSRU, FAIUM
Joseph F. Polak, MD, MPH
vii
ABOUT THE EDITORS
John S. Pellerito, MD, FACR, FSRU, FAIUM, is Associ-
ate Professor of Radiology at Hofstra North Shore-LIJ
School of Medicine. He is Associate Chairman of Stra-
tegic Planning and Technology at North Shore Uni-
versity Hospital in Manhasset, New York. He is also
Chief of the Division of Ultrasound, CT, and MRI;
the Director of the Peripheral Vascular Laboratory at
North Shore University Hospital; the Director of the
Body Imaging Fellowship Program; and the author of
multiple original articles, book chapters, web lectures,
and DVD programs. His practice focuses on cardiovas-
cular and gynecologic diseases. His current interests
include new imaging technologies and approaches to
the diagnosis of vascular and oncologic diseases. He is
an acclaimed national and international speaker and
contributes to multiple CME programs. Dr. Pellerito
holds multiple editorial appointments and is a board
examiner for the American Board of Radiology. He
has served on the board of the Intersocietal Accredi-
tation Commission for the accreditation of vascular
laboratories and American Institute of Ultrasound in
Medicine. He is a fellow of the American College of
Radiology, Society of Radiologists in Ultrasound, and
American Institute of Ultrasound in Medicine. He and
his wife, Elizabeth, have three children: John, Alana,
and Daniel.
Joseph F. Polak, MD, MPH, is Professor of Radiology
at Tufts University School of Medicine, Director of
the Ultrasound Reading Center at Tufts Medical Cen-
ter, as well as Chief of Radiology at the Lemuel Shat-
tuck Hospital in Boston, Massachusetts. A graduate of
McGill University Medical School, he holds a master’s
degree in public health from the Harvard School of
Public Health. He has co-authored more than 250
peer-reviewed articles and more than 80 non–peer-
reviewed articles and chapters. He has served on the
editorial board of Radiology, the Journal of Neuroimag-
ing, the Journal of Vascular Ultrasound, and the Journal
of Ultrasound in Medicine. He is a prior president of the
Intersocietal Accreditation Commission for the accred-
itation of vascular laboratories. His research interests
include interventional radiology, non-invasive vascu-
lar imaging, and the development of biomarkers for
the detection and monitoring of early atherosclero-
sis. He has been principal investigator on two RO-1
grants studying the progression of atherosclerosis
with carotid artery intima-media thickness and co-
investigator on multiple other NIH grants.
ix
PREFACE
The sixth edition of Introduction to Vascular Ultra- leaders in vascular ultrasound. His curriculum
sonography is a major update to our previous vitae includes many original papers utilizing
editions. First, I would like to welcome my new duplex ultrasound in diagnosis of carotid and
co-editor, Joseph F. Polak, to this edition. Jo and venous disease. His expertise extends to 10 chap-
I have collaborated for many years on multiple ters in this edition. New topics include evaluation
projects and at numerous meetings, most nota- of the abdominal aorta, screening for vascular
bly our Current Practice of Vascular Ultrasound disease, and correlative imaging with CT and MR
program, which is approaching its twentieth angiography.
anniversary. Having produced separate vascular There are 29 authors involved in this edition.
publications, we decided to collaborate on this All the authors have contributed to the field of
edition, hoping to create the definitive vascular vascular ultrasound, and we are proud to include
ultrasound textbook. We are very pleased to find their material. Each has made a substantial contri-
that this partnership produced an inclusive tome bution with expanded and new chapters. Signifi-
that surpassed our expectations. We added sev- cant additions to this edition include enhanced
eral new chapters that focus on growing areas of versions of the role of ultrasound contrast in vas-
vascular ultrasound and updated previous chap- cular imaging, the role of ultrasound in manage-
ters with the assistance of leading experts in our ment of cerebrovascular disease, and evaluation
field. We believe the most popular text on vascu- of the hepatic vasculature. New topics include
lar ultrasound is now significantly improved. assessment of carotid interventions, evaluation of
As an interventional radiologist and vascular organ transplants, and accreditation and the vas-
specialist, Dr. Polak brings extraordinary expe- cular laboratory.
rience in medical imaging and vascular medi-
cine to this edition. Jo Polak is one of the true John S. Pellerito, MD, FACR, FSRU, FAIUM
xi
CONTRIBUTORS
Andrei V. Alexandrov, MD Brian J. Burke, MD, RVT
Professor and Director Attending Radiologist
Comprehensive Stroke Center Department of Radiology
University of Alabama Hospital North Shore University Hospital;
Birmingham, Alabama Assistant Professor
Department of Radiology
Clotilde Balucani, MD
Hofstra North Shore-LIJ School of Medicine
Department of Neurology
Manhasset, New York
University of Perugia
Perugia, Italy; Stefan A. Carter, MD, MSC, FRCP(C)
Research Fellow Professor of Physiology and Medicine
Comprehensive Stroke Center University of Manitoba
University of Alabama Hospital Winnipeg, Manitoba, Canada
Birmingham, Alabama
John J. Cronan, MD
Dennis F. Bandyk, MD Professor and Chairman
Professor of Surgery Brown Alpert Medical School;
University of South Florida Department of Diagnostic Imaging
College of Medicine Radiologist-in-Chief
Tampa, Florida Rhode Island Hospital
Providence, Rhode Island
Phillip J. Bendick, PhD
Director Joshua Cruz, RVT
Peripheral Vascular Diagnostic Center Technical Director and Manager
William Beaumont Hospital Yale Vascular Laboratory
Royal Oak, Michigan Yale University School of Medicine
New Haven, Connecticut
Carol B. Benson, MD
Professor of Radiology Daniel T. Ginat, MD, MS
Harvard Medical School; Radiology Resident
Director of Ultrasound University of Rochester Medical Center
Co-Director of High Risk Obstetrical Ultrasound Rochester, New York
Brigham and Women’s Hospital
Edward G. Grant, MD
Boston, Massachusetts
Chairman and Professor
George L. Berdejo, BA, RVT Department of Radiology
Director, Vascular Ultrasound Imaging Services University of Southern California
Moses, North, and Weiler-Einstein Divisions University Hospital
Division of Vascular Surgery Los Angeles, California
Department of Cardiovascular and Thoracic
Ulrike M. Hamper, MD, MBA
Surgery
Professor of Radiology, Urology, and Pathology;
Montefiore
Director, Division of Ultrasound
Bronx, New York
Russell H. Morgan Department of Radiology
Edward I. Bluth, MD, FACR and Radiological Science
Professor The Johns Hopkins University
Ochsner Clinical School School of Medicine
University of Queensland School of Medicine; Baltimore, Maryland
Chairman Emeritus Radiology
Ochsner Health System
New Orleans, Louisiana
xiii
xiv CONTRIBUTORS
Kelly Hodgkiss-Harlow, MD Daniel A. Merton, BS, RDMS, FSDMS, FAIUM
Division of Vascular and Endovascular Surgery Clinical Instructor and Technical Coordinator
University of South Florida College of Medicine of Research
Tampa, Florida Jefferson Ultrasound Research and Education
Institute
Sandra Katanick, RN, RVT, FSVU, CAE
Department of Radiology
Chief Executive Officer
Jefferson Medical College
Intersocietal Accreditation Commission
Thomas Jefferson University
Ellicott City, Maryland
Philadelphia, Pennsylvania
Gregory M. Keck, MD
William D. Middleton, MD, FACR
Interventional Radiologist
Professor of Radiology
Southwest Medical Imaging Associates;
Mallinckrodt Institute of Radiology
Department of Radiology
Washington University in St. Louis
Midland Memorial Hospital
St. Louis, Missouri
Midland, Texas
Darius G. Nabavi, MD
Evan C. Lipsitz, MD
Professor
Associate Professor of Surgery
Department of Neurology
Albert Einstein College of Medicine;
Klinikum Neukölln
Medical Director, Vascular Diagnostic
Berlin, Germany
Laboratory Services
Chief, Division of Vascular Surgery Laurence Needleman, MD
Department of Cardiovascular and Thoracic Medical Director, Noninvasive Vascular
Surgery Laboratory
Montefiore Thomas Jefferson University Hospitals;
Bronx, New York Associate Professor of Radiology
Jefferson Medical College
Mark E. Lockhart, MD, MPH
Thomas Jefferson University
Professor of Radiology
Philadelphia, Pennsylvania
Chief, Body Imaging Section
Chief, GU Radiology Marsha M. Neumyer, BS, RVT, FSDMS, FSVU,
University of Alabama at Birmingham FAIUM
Birmingham, Alabama International Director
Vascular Diagnostic Educational Services
Mahan Mathur, MD
Harrisburg, Pennsylvania
Department of Diagnostic Radiology
Yale University School of Medicine Shirley M. Otis, MD
New Haven, Connecticut Director
The Brain Research and Treatment Center
Michelle Melany, MD
Scripps Clinic
Clinical Professor of Radiology
La Jolla, California
University of California Los Angeles David
Geffen School of Medicine; John S. Pellerito, MD, FACR, FSRU, FAIUM
Vice Chair of Radiology Associate Professor of Radiology
Greater Los Angeles VA Medical Center; Hofstra North Shore-LIJ School of Medicine;
Chief of Women’s Imaging Associate Chairman
Cedars Sinai Imaging Medical Group Department of Radiology
Los Angeles, California Chief, Division of Ultrasound, CT, and MRI
Director, Peripheral Vascular Laboratory
North Shore University Hospital
Manhasset, New York
CONTRIBUTORS xv
Joseph F. Polak, MD, MPH Deborah Rubens, MD
Professor of Radiology Professor of Imaging Sciences, Oncology, and
Tufts University School of Medicine; Biomedical Engineering
Vice Chair of Business Development Associate Chair, Imaging Sciences
Tufts Medical Center Associate Director for the Center for Biomedical
Boston, Massachusetts; Ultrasound
Chief of Radiology University of Rochester Medical Center
Lemuel Shattuck Hospital Rochester, New York
Jamaica Plain, Massachusetts
Leslie M. Scoutt, MD
Margarita V. Revzin, MS, MD Professor of Diagnostic Radiology and Surgery
Assistant Professor of Radiology Yale University School of Medicine;
Yale University School of Medicine Chief, Ultrasound Service
New Haven, Connecticut Medical Director, Non-Invasive Vascular
Laboratory
E. Bernd Ringelstein, MD
Yale-New Haven Hospital
Professor of Neurology
New Haven, Connecticut
Department of Neurology
University Hospital Münster Steven R. Talbot, RVT, FSVU
Münster, Germany Research Associate
Division of Vascular Surgery
Martin A. Ritter, MD
Technical Director, Vascular Laboratory
Consultant Neurologist
Cardiovascular Services
Head of the Stroke Unit
University of Utah Medical Center
Department of Neurology
Salt Lake City, Utah
University Hospital Münster
Münster, Germany James A. Zagzebski, PhD
Professor and Chairman
Michelle L. Robbin, MD, MS
Department of Medical Physics
Professor of Radiology and Biomedical
University of Wisconsin
Engineering
Madison, Wisconsin
Chief of Ultrasound
University of Alabama at Birmingham R. Eugene Zierler, MD
Birmingham, Alabama Professor of Surgery
University of Washington School of Medicine;
Kathryn A. Robinson, MD
Medical Director, D.E. Strandness, Jr., Vascular
Mallinckrodt Institute of Radiology
Laboratory
Washington University in St. Louis
University of Washington Medical Center and
St. Louis, Missouri
Harborview Medical Center
Seattle, Washington