IMAGE-DIRECTED DOPPLER ULTRASOUND IN THE DIAGNOSIS OF LOWER-LIMB VENOUS INSUFFICIENCY

Ninety-eight legs in 73 patients were evaluated with image-directed Do ppler ultrasound for suspected chronic venous insufficiency. Examinati ons of the entire venous system were performed to determine lumen pate ncy and valvular competence. Reflux during Valsalva maneuver in the fe moral and great saphenous vein, and, after release of distal compressi on in the popliteal vein, indicated valvular incompetence. Twenty limb s had normal veins; Baker's cysts were found in three. Superficial ven ous insufficiency was found in 25 cases. Deep reflux, either alone or in combination with superficial reflux, was the predominant pathologic al feature (53 legs). Photoplethysmographic studies of the veins were performed on 24 limbs. Image-directed Doppler ultrasound was more succ essful in defining the exact site of venous incompetence and in detect ing nonvenous pathology. By the combination of real-time imaging of th e vein with gated Doppler sonography of flow, image-directed Doppler s onography is becoming the method of choice for the investigation of ch ronic venous insufficiency. (C) 1994 John Wiley and Sons, Inc.