Accreditation Support

Exam Requirements: Peripheral Ultrasound Accreditation

Choose one exam: Arterial OR Venous

Arterial

Choose one of these

Arterial Occlusive Disease – Lower Extremities

• Longitudinal grey scale images

  • Common femoral artery

  • Proximal profunda femoris artery

  • Superficial femoral artery - proximal, mid and distal

  • Popliteal artery - proximal and distal

  • Anterior tibial artery

  • Posterior tibial artery

  • Dorsalis pedis artery

• Longitudinal color Doppler images

  • Common femoral artery

  • Proximal profunda femoris artery

  • Superficial femoral artery - proximal, mid and distal

  • Popliteal artery - proximal and distal

  • Anterior tibial artery
  • Posterior tibial artery
  • Dorsalis pedis artery

• Longitudinal Spectral Doppler waveform with color Doppler evaluation

  • Common femoral artery

  • Proximal profunda femoris artery

  • Superficial femoral artery - proximal, mid and distal

  • Popliteal artery - proximal and distal

  • Anterior tibia artery

  • Posterior tibial artery

  • Dorsalis pedis artery

Bypass Graft/Stent

• Longitudinal gray scale images of graft/stent and anastomoses

• Longitudinal color Doppler images of graft/stent and anastomoses

• Spectral Doppler waveforms to include peak systole and end diastole measurements

  • Proximal native vessel

  • Proximal anastomosis/edge of stent

  • Proximal, mid and distal segments of graft/stent (at a minimum)

  • Distal anastomosis/edge of stent

  • Distal native run-off vessel

• Direction of flow documented in native run off vessel distal to graft

Venous

Choose one of these

Thrombosis – Lower Extremities 

• A bilateral exam should be submitted

• Transverse gray scale with & without compression images

  • Common femoral vein

  • Saphenofemoral junction

  • Proximal profunda femoris vein

  • Femoral vein – proximal, mid and distal

  • Popliteal vein

• Longitudinal color and/or spectral Doppler waveform images

  • Saphenofemoral junction

  • Proximal profunda femoris vein

  • Femoral vein – proximal, mid and distal

• Spectral Doppler wave form demonstrating spontaneous flow and respiratory phasicity

  • Common femoral vein or external iliac vein

  • Popliteal vein

• Calf veins as clinically indicated

Vein mapping

Complete evaluation of appropriate superficial venous system using grey scale including axial diameter +/- distance from skin surface:

• Great or small saphenous of leg

• Cephalic vein of upper arm/forearm and
• Basilic vein of upper arm/forearm 

Incompetence 

Perform a complete Thrombosis - Lower Extremities exam first, then add the reflux assessment below:

Documentation of direction of flow with color and spectral Doppler waveform following augmentation maneuvers or Valsalva (in the upper thigh) with the patient in the semi-upright or upright position. Length of time of reflux must be measured in at least one location within the superficial system.

• Common femoral vein

• Femoral vein

• Popliteal vein

• Great saphenous vein including SFJ and throughout thigh at a minimum

• Additional imaging inferior to knee, if appropriate

  • GSV

  • Small saphenous vein including saphenopopliteal junction

• Assess for perforators as clinically indicated

Thrombosis – Upper Extremities

• Transverse gray scale without and with compression images

  • Internal jugular vein

  • Axillary vein

  • Brachial vein

  • Basilic vein to the level of the antecubital fossa

  • Cephalic vein to the level of the antecubital fossa

• Longitudinal gray scale images

  • Internal jugular vein

  • Subclavian vein

  • Axillary vein

  • Brachial veins

• Longitudinal color Doppler images

  • Internal jugular vein

  • Subclavian vein

  • Axillary vein

  • Brachial veins

• Spectral Doppler wave form images

  • Internal jugular vein - bilaterally

  • Subclavian vein - bilaterally

  • Axillary vein

  • Brachial veins

Exam Requirements: Cerebrovascular Ultrasound Accreditation

(Bilateral Duplex Carotid Ultrasound)

• Transverse gray scale images:

  • Common carotid artery – proximal and distal

  • Bifurcation

  • Any area of significant plaque

• Longitudinal grey scale images:

  • Common carotid artery – proximal and distal

  • Internal carotid artery – proximal

  • External carotid artery – proximal

• Longitudinal color Doppler images:

  • Common carotid artery – proximal and distal

  • Internal carotid artery – proximal

  • External carotid artery – proximal

• Longitudinal spectral Doppler wave form with color Doppler evaluation:

  • Common carotid artery – proximal and distal

  • Internal carotid artery – proximal, mid and distal 

  • External carotid artery – proximal

  • Vertebral artery

Exam Requirements: Abdominal Ultrasound Accreditation

 Choose one exam: Liver or Renal

Liver

 Choose one of these

Liver Vasculature

• Complete gray scale survey of liver parenchyma in longitudinal (at least 3 images each of the left and right lobes)

• Complete gray scale survey of liver parenchyma of liver parenchyma in transverse (at least 3 images each of the left and right lobes)  

• Gray scale images of vascular anatomy including vessel labeling

  • Portal veins-main, right and left

  • Hepatic veins – right, middle and left

  • Inferior vena cava

  • Splenic vein – posterior to pancreas

• Color or power Doppler images

  • Portal veins - main, right and left

  • Hepatic veins – right, middle and left

  • Hepatic artery

  • Inferior vena cava

  • Splenic vein - posterior to pancreas

• Spectral Doppler waveform images

  • Portal veins – main (angle correction required), right and left

  • Hepatic veins - right, middle and left

  • Hepatic artery (angle correction required)

  • Inferior vena cava

  • Splenic vein – posterior to pancreas

Liver Transplantation

• Complete gray scale survey of liver parenchyma in longitudinal (at least 3 images each of the left and right lobes)

• Complete gray scale survey of liver parenchyma of liver parenchyma in transverse (at least 3 images each of the left and right lobes)  

• Gray scale images of vascular anatomy including vessel labeling

  • Main portal vein and anastomosis

  • Hepatic veins – right, middle and left

  • Inferior vena cava

  • Splenic vein – posterior to pancreas

• Color or power Doppler images

  • Portal veins - main, right, left and site of anastomosis

  • Hepatic veins – right, middle and left

  • Hepatic artery – main, right, left and site of anastomosis

  • Inferior vena cava

  • Splenic vein - posterior to pancreas

• Spectral Doppler waveform images

  • Portal veins – main (angle correction required), right, left and site of anastomosis

  • Hepatic arteries (angle correction required) - main, right, left and site of anastomosis

  • Hepatic veins - right, middle and left

  • Inferior vena cava

  • Splenic vein – posterior to pancreas

TIPS

• Complete gray scale survey of liver parenchyma in longitudinal (at least 3 images each of the left and right lobes)

• Complete gray scale survey of liver parenchyma of liver parenchyma in transverse (at least 3 images each of the left and right lobes)  

• Gray scale images of vascular anatomy including vessel labeling

  • Main portal vein

  • Hepatic veins – right, middle and left

  • Inferior vena cava

  • Splenic vein – posterior to pancreas

  • TIPS

• Color or power Doppler images

  • Portal veins - main, right and left

  • Hepatic veins – right, middle and left

  • Hepatic artery

  • Inferior vena cava

  • Splenic vein - posterior to pancreas

  • TIPS

• Spectral Doppler waveform images

  • Portal veins (angle correction required) – main, right, left and proximal to TIPS

  • Hepatic veins - right, middle, left and distal to TIPS

  • Hepatic artery (angle correction required)

  • Inferior vena cava

  • Splenic vein – posterior to pancreas

  • TIPS (angle correction required) – proximal, mid and distal

Renal 

Choose one of these

Renal Artery Stenosis

• Complete gray scale documentation of kidneys in longitudinal (At least 3 images; images without and with calipers represent 1 image)

• Complete gray scale documentation of kidneys in transverse (At least 3 images)

• Renal length

• Spectral Doppler waveform images

  • Aorta (angle correction required) - at or just above the origin of the renal arteries

  • Main renal artery (angle correction required) - proximal, mid and distal

  • Main renal vein

  • Upper and lower pole segmental or interlobar arteries documenting RI or AI/AT

Renal Vein Thrombosis

• Complete gray scale documentation of kidneys in longitudinal (At least 3 images; images without and with calipers represent 1 image)

• Complete gray scale documentation of kidneys in transverse (At least 3 images)

• Renal length

• Gray scale images

  • Renal veins

  • Inferior vena cava

• Color Doppler images

  • Main renal arteries

  • Renal veins

  • Inferior vena cava

• Spectral Doppler waveform images

  • Main renal artery (angle correction required)

  • Main renal vein

  • Intrarenal artery – upper and lower pole

  • Inferior vena cava

Renal Transplant 

(Renal Artery Thrombosis)

• Complete gray scale documentation of kidneys in longitudinal (At least 3 images; images without and with calipers represent 1 image)

• Complete gray scale documentation of kidneys in transverse (At least 3 images)

• Renal length

• Color Doppler images

  • Main renal arteries

  • Main renal vein

  • Proximal iliac artery

  • Draining iliac vein

• Spectral Doppler waveform images

  • Renal artery (angle correction required) - anastomosis, proximal, mid and distal

  • Renal vein – anastomosis and proximal

  • Proximal iliac artery (angle correction required)

  • Draining iliac vein

  • Upper and lower pole segmental or interlobar arteries documenting RI or AI/AT

Exam Requirements: Deep Abdominal Ultrasound Accreditation

Choose One Exam: Aorta OR Inferior Vena Cava/Draining Veins

Aorta

• Longitudinal gray scale images without and with AP measurements

  • Aorta – proximal, mid and distal

  • Right common iliac artery

  • Left common iliac artery

• Transverse gray scale images without and with transverse measurements

  • Aorta – proximal, mid and distal

  • Bifurcation into proximal common iliac arteries

• Color and/or spectral Doppler waveform of the distal aorta

Inferior Vena Cava and Draining Veins

• Longitudinal gray scale images without and with measurements

  • Inferior vena cava – proximal, mid and distal

  • Right common iliac vein

  • Left common iliac vein

• Transverse gray scale images

  • Inferior vena cava – proximal, mid and distal

  • Bifurcation into proximal common iliac veins

• Color and/or spectral Doppler waveform

Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes