Vascular Sonography Terms

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Adventitia

Aliasing

Amaurosis
fugax

Anastomosis

Anechoic

The outermost covering of a structure or

organ. Tunica adventitia refers to the outer
coat of an artery. The strongest layer, it is
composed of collagenous and elastic
fibers.
An artifact or phenomenon that occurs
when measured Doppler frequencies
exceed the Nyquist limit. The frequency of
the resulting waveform is lower than the
actual signal and is sometimes
demonstrated by "wrapping around" the
spectral baseline.
Temporary partial of total blindness often
resulting from partial or total occlusion of
the retinal arteries. A type of transient
ischemic attack (TIA).
A natural or surgical connection between
blood vessels. Commonly used to describe
an area of a bypass: e.g., proximal
anastomosis. Surgical descriptions may be
"end-to-end" or "end-to-side" to explain
how the vessels were connected.
Area which does not reflect acoustic
energy (echoes).

6.

Aneurysm

A ballooning of an artery or vein, caused

by thinning or weakening of the wall; may
be congenital or the result of disease.

7.

Angioplasty

A therapeutic modality in which a catheter

is passed through a blockage in an artery
and inflated, compressing the blockage,
thereby increasing the opening in the
artery.

Arteriovenous
fistula (AVF)

An abnormal communication between an

artery and a vein. May occur secondary to
trauma or surgery (post bypass).

Arteriovenous
malformation
(AVM)

Another name for an abnormal

communication between an artery and
vein. AVM is used more frequently than
AVF to refer to congenital abnormalities.

17.

Atheroma

Lipid deposits in the intima of arteries.

Plural: atheromata.

18.

Atherosclerosis

A form of arteriosclerosis in which the

inner layer of the artery becomes thick and
irregular due to fatty deposits.

19.

Auscultation

The act of listening to sounds within the

body; one auscultates with a stethoscope.

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Bidirectional

Referring to two directions. Bidirectional

Doppler is capable of detecting flow in two
directions: forward and reverse.

21.

Bruit

AN abnormal sound (pulse) heard on

auscultation caused by turbulence. In a
cardiac exam, this sound is called a
murmur. A murmur is a bruit originating in
the heart.

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Carotid body

A small mass of cells and nerve endings

normally located in the carotid sinus.
These cells respond to changes in
concentration of oxygen in the blood and to
changes in blood pressure by altering
respiration and heart rate.

Carotid body
rumor

A highly vascularized mass located in the

area of the carotid body. AKA:
Paraganglioma.

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Antegrade

Forward blood flow, usually describing

flow toward the probe. /Flow in "correct"
direction.

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Carotid sinus

The slight dilation in the carotid

bifurcation in which the carotid body is
found. AKA: Bulb

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Anterior

Before or in front of.

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Caudal

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Anticoagulant

Pharmaceutical agent, such as Heparin,

used to inhibit blood clotting.

Inferior in position. Similar to caudal,

which is thought of as posterior in
position. From caudal: tail.

Arterial
insufficiency

Lack of adequate arterial blood supply due

to stenosis or occlusion.

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Cephalad

Toward the head.

Arterial
occlusive
disease

Any disease process that results in

occlusion of an artery or arteries.

Cerebral
vascular
accident (CVA)
AKA:Stroke

13.

Arteriosclerosis

A variety of conditions leading to arterial

thickening and hardening with loss of
elasticity.

Lack of blood supply to the brain caused by:

Thrombosis: Blockage in a vessel.
Hemorrhage: Rupture of vessel.
Embolus: A clot which has traveled from
another part of the body to occlude a vessel.
Pressure on a vessel: Pressure caused by an
external element or event, for example, by a
tumor.

14.

Arteritis

Inflammation of the arteries. Various types

include Buerger's Disease, Takayasu and
Giant Cell. Also seen in scleroderma and
systemic lupus erthematosis (SLE).

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Claudication

Pain and discomfort ("tightness") in the

extremity or extremities due to arterial
insufficiency during exercise. Usually
intermittent, it is relieved with rest.
Commonly the first sign of arterial disease in
the affected extremity.

Collateral
circulation

Flow established through accessory blood

vessels (anastomotic) as a result of
compromised or occluded circulation.
Development of "collaterals" is critical with
reduced cerebral circulation, and, in some
cases, prevents symptoms.

Color flow
imaging
(CFI)

A type of pulsed Doppler in which frequency

shift are displayed in color after being coded
for velocity and direction.

Continuouswave
Doppler
(CW)

A Doppler modality using two piezoelectric

crystals, one for transmitting and the other for
receiving. It is NOT range specific and,
subsequently, with detect flow at an depth
governed by the frequency of the transducer.
(See pulsed doppler)

Contralateral

Pertaining to the opposite side of the body.

Opposite of ipsilateral.

Deep venous
thrombosis
(DVT)

Also called thrombophlebitis. An aggregation

of blood elements (platelets, fibrin, red and
white blood cells) formed in the deep venous
system, involving one or more veins. The clot
may partially or totally occlude the vessel.
Potentially life-thretening.

Dependent
rubor

A sign indicating significant arterial disease

in which the foot or limb becomes deep red in
the dependent position. (See rubor)

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Distal

Farther from the midline or point of origin.

Opposite of proximal.

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Diastole

The portion of the cardiac cycle in which the

ventricles fill with blood. This is considered
the "rest" period since the heart is not actively
pumping.

Dissecting
aneurysm

Splitting of the arterial wall by blood entering

a tear in the intima or by intramural
hemorrhage. Most common in aortic arch.
Usually poor prognosis.

Doppler

A diagnostic modality in which an ultrasound

beam is sent into the body. The ultrasound is
reflected from moving structures at a
frequency higher or lower than the
transmitted frequency. The resultant
frequency shift is amplified and presented as a
sound by the Doppler instrument.

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Doppler effect
or principle

The phenomenon is named after Christian

Andreas Doppler, the Austrian physicist
who first investigated this principle. The
effect is a change in frequency of waves
(whether light or sound) caused by the
motion of the source or the observer.

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Duplex

Twofold. Duplex imaging is performed with

instrumentation in which high resolution
B-mode imaging is incorporated with
Doppler ultrasound.

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Echogenic

Containing structures capable of producing

echoes.

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Embolism

A clot that was formed in one part of the

body and has traveled to another vessel
resulting in an obstruction. An emboli may
also be formed by air, fat, tumor or toher
substances. Plural is emboli.

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Extracranial

Anatomic structures outside the skull.

False
aneurysm

A pulsating hematoma in communication

with a ruptured artery. Most commonly
found at sites of surgical anastomoses.
AKA: Pseudo

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Gray Scale

A type of processing used in the display of Bmode ultrasound in which the intensity or
brightness of the displayed dot is
proportional to the strength of the returning
echo.

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Hematoma

A mass of blood (usually clotted) confined to

tissue. A hematoma is the result of a
ruptured artery.

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Heterogeneous

Used to describe plaque morphology. A

mixed composition of tissue type within one
atherosclerotic deposit in an artery. (See
homogeneous)

48.

Homogeneous

Used to describe plaque morphology. A

homogeneous stenosis is composed of one
type of tissue. A stenosis may be calcific,
soft or dense but only one type throughout
the lesion. (See heterogeneous)

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Hyperechoic

Consisting primarily of bright, highintensity echoes; used to describe calcific

plaque.

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Hypertension

High blood pressure. (HTN)

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Hypotention

Low blood pressure.

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Indirect

Indirect tests give information regarding an

artery or arteries without directly examining
the vessel(s) in question. Examples of
indirect test are ocular plethysmography
and periorbital Doppler. Opposite or direct.

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Intima

The innermost layer of all arteries except

capillaries. Sometimes referred to as the tunica
intima or endarterium. This layer is composed
of a smooth lining or endothelial cells,
connective tissue , and an internal elastic
membrane.

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Ipsilateral

Pertaining to the same side of the body.

Opposite of contralateral.

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Intracranial

Reffering to structures located within the skull.

Opposite of extracranial

56.

Ichemia

Reduction in blood supply due to obstruction or

vasocronstricion. Ischemic changes or signs
int he extremities are usually more urgent than
those of claudication. The symptoms can be
transient or persistent.

Laminar
flow

Used to describe normal blood flow in which

the blood cells move uniformly: faster in the
center and slower near the walls of the artery.

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Lateral

Pertaining to the side. Opposite of medial.

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Lesion

A pathologic change in tissue. a lesion seen on

the wall of an artery during a noninvasive
exam suggests and atherosclerotic blockage.

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Lumen

the space within a tube or tube-like structure.

61.

Lysis

the resolution of a fever or disease. the

decomposition of blood cells or clot that occurs
after administration of anticoagulant drugs.

62.

Media

the tunica media, or middle layer or arteries, is

the thickest portion and consists of smooth
muscle cells with elastic fiber.

63.

meidal

Toward the mid-line or center. Opposite of

lateral.

64.

Noninvasive

Not penetrating or invading the body. Vascular

examinations using Doppler and/or
plethysmographic techniques are noninvasive.

65.

Occluded

Shut off or closed. refers to only those openings

that are completely blocked, e.g., occlusion or
partial blockage.

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Palpation

Examination by touch for diagnostic purposes.

A physician often palpates pulses.

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Paresis

Partial or incomplete paralysis.

68.

patent

Used to describe and open vessel. E.g., "The

patency rate of fem-pop grats...: The posterio
tibial artery is patent..."

69.

Peripheral

relating to the periphery (ouside the center).

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Phlebitis

Inflammation of a vein.

Piezoelectric
crytal

A crystal that when exited by electric charges

vibrates and emits ultrasound waves. When
the crystal is excited by ultrasound waves, it
sends an electric signal which, in turn, can be
processed to indicate frequency of the
ultrasound energy received.

72.

Plaque

Atherosclerotic substance which is deposited

within the intima and projects into arterial
lumen. Histologically, it can be composed of
fat, collagen, hemorrhage and calcium.

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Posterior

Behind or toward the back.

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Proximal

Closer to the point of origin. Opposite of distal.

E.g., The elbow is proximal to the hand.

Pulmonary
Embolism
(PE)

Any obstruction in the lung vasculature. It is

believed that most PEs are clots originating in
the deep venous system int eh legs.

Pulsed
Doppler
(PW)

A Doppler instrument using one piezoelectric

crystal that intermittently transmits ultrasound
and detects returning signals. This allows
range resolutions for detecting flow from a
given depth.

77.

Real time

Dynamic imaging. A type of B-mode

ultrasound in which a beam of sound is swept
across the area of interest at a rapid rate. three
types of real time scanners are; mechanical,
linear array, and phased array.

78.

Rest pain

Pain experienced by a patient at rest, usually

noticed, first, at night in an extremity with
compromised arterial flow. Indicative of severe
arterial disease.

retrograde
flow

Flow away from the transducer. Opposite of

antegrade flow (Flow in "wrong" direction).

Sample
volume

A three-dimensional burst of excessive growth

of fibrous tissue. In the vascular system, the
walls of the arteries become hardened or
thickened.

Segmental
pressures

Used to assess arterial flow primarily in the

lower extremities. Blood pressure cuffs are
applied at high thigh, low thigh, below the
knee and above the ankle. Using Doppler
ultrasound, systolic blood pressures are
measured at each of these levels.

Spectral
broadening

widening of the graphic display of blood flow

velocities due to increased number of returning
echoes. Indicates turbulence.

83.

stasis

stagnation of blood flow thought to contribute

to formation of DVT. Stasis ulcers or venous
ulcers are signs of venous insufficiency.

84.

Stenosis

Constrictions or narrowing of lumen.

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85.

Systole

The portion of the cardiac cycle during

which the ventricles are contracting. the
systolic portion of the blood pressure is
the first or higher number.

86.

Thrombosis

The formation of blood clot

87.

Thrombus

A blood clot

88.

Transcranial

Performed through the cranium

Transducer
(TRDX)

A device which converts one form of

energy to another. In ultrasound, the
probe contains a crystal which converts
electrical energy into ultrasound and
then back again.

Transient
Ischemic Attack
(TIA)

A temporary episode of neurologic

symptoms caused by a reduction in blood
flow to the brain. A TIA often is a
prelude to stroke.

91.

Turbulence

disturbance in blood flow in which

eddies and vortices are formed as a result
of a stenosis, aneurysm, and/or kink.
Turbulence may cause a bruit.

92.

Ulceration

A lesion or cavitations along the surface

of the skin (as in venous ulcers) or in
atherosclerotic plaque within an artery.

93.

Ultrasound

High frequency sound beyond the range

of hearing (greater than 20,000
cycles/second)

Valsalva's
maneuver

Contraction of the muscles in the chest,

abdomen, and diaphragm to result in
forced expiration. This raises the
intrathoracic pressure, decreases intraabdominal pressure, slows the pulse,
decreases return of flow to the heart and
increases venous pressure. sometimes
performed during a Doppler venous
exam.

95.

Vasoconstriction

Narrowing of vessel lumen because of

contraction of the muscular wall.
Opposite of vasodialtion.

96.

Ataxia

muscular dis-coordintaion

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Paralysis

loss or impairment of motor function

98.

Paresthesia

abnormal sensation, tingaling in fingers

and toes.

99.

Dysarthria

difficulty articulating speech

100.

Dysphagia

difficulty saying words in proper order.

101.

Dysphagia

trouble swallowing

102.

Syncope

loss of consciousness, due to lack of

blood flow to the brain. "I passed out"

103.

Drop attack

Collapse and fall but still conscious. "I

just fell down"

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104.

Stent

same technology as angioplasty but uses

medication-coated metal.

105.

Hemodynamics

The study of blood flow characteristics.

Range
resolution

Known exactly where signal came from

106.