COLOR DOPPLER SONOGRAPHY OF THE THORACIC INLET VEINS

Color duplex sonography of the thoracic inlet veins produces a spectru m of normal and abnormal findings, These vessels include the internal jugular, innominate, subclavian, and axillary veins. Although venograp hy is the traditional means of imaging these veins, ultrasound lends i tself to assessment of these vessels by providing anatomic and hemodyn amic information, Advances in gray-scale resolution and color Doppler technology permit direct visualization of thrombus, stenosis, collater al vessels, catheters, and stents, as well as sensitive spectral wavef orm analysis, Abnormal findings in the thoracic inlet veins include lo cally elevated velocities at stenoses with low velocities peripherally , Thrombus, extrinsic compression, and collateral vessels may also pro duce abnormal findings, Common interpretive pitfalls are caused by tra nsducer pressure, deep inspiration, slow flow, collateral veins, large -bore catheters, and hemodialysis fistulas, A thorough knowledge of th e regional anatomy, normal and abnormal waveforms, and commonly encoun tered pitfalls will optimize the accuracy of color duplex sonography o f the thoracic inlet veins.