Revision History
One normal exam is required from each exam type performed at the site:
Peripheral (Arterial or Venous)
Cerebrovascular
Abdominal (Liver or Renal)
Deep Abdominal
Complete documentation/survey means a series of several images throughout the entire organ in two planes. For example, from one side of the organ to the other in the longitudinal plane and from superior to inferior in the transverse plane.
Anatomy should be intentionally imaged in an organized fashion and correctly labeled for clarity.
Exam Requirements: Peripheral Ultrasound Accreditation
Choose one exam: Arterial OR Venous
Arterial
Choose one of these
Arterial Occlusive Disease – Lower Extremities
A bilateral exam should be submitted
Longitudinal gray scale images
Common femoral artery
Proximal profunda femoris artery
Superficial femoral artery - proximal, mid, distal
Popliteal artery - proximal and distal
Anterior tibial artery
Posterior tibial artery - distal
Dorsalis pedis artery
Longitudinal stand-alone color Doppler images
Common femoral artery
Proximal profunda femoris artery
Superficial femoral artery - proximal, mid, distal
Popliteal artery - proximal and distal
Anterior tibial artery
Posterior tibial artery - distal
Dorsalis pedis artery
Longitudinal spectral Doppler waveform with color Doppler evaluation
Common femoral artery
Proximal profunda femoris artery
Superficial femoral artery - proximal, mid, distal
Popliteal artery - proximal and distal
Anterior tibial artery
Posterior tibial artery - distal
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
Static transverse gray scale images without and with compression OR transverse gray scale cine clips without and with compression
Common femoral vein - superior to and separate from the saphenofemoral junction
Saphenofemoral junction
Proximal profunda femoris vein
Femoral vein – proximal, mid, distal
Popliteal vein
Longitudinal color and/or spectral Doppler waveform images
Saphenofemoral junction
Proximal profunda femoris vein
Femoral vein – proximal, mid, distal
Spectral Doppler waveform demonstrating spontaneous flow and respiratory phasicity
Common femoral vein or external iliac vein
Popliteal vein
Vein mapping
Complete evaluation of appropriate superficial venous system using gray scale including axial diameter +/- distance from skin surface:
Great or small saphenous of leg
OR
Cephalic vein of upper arm/forearm and
Basilic vein of upper arm/forearm
Images to note thrombus, wall thickening, calcification or branching should be obtained
Incompetence
Static transverse gray scale images without and with compression OR transverse gray scale cine clips without and with compression.
Common femoral vein - superior to and separate from the saphenofemoral junction
Saphenofemoral junction
Proximal profunda femoris vein
Femoral vein - proximal, mid, distal
Popliteal vein
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
Saphenofemoral junction
Proximal profunda femoris vein
Femoral vein - proximal, mid, distal
Popliteal vein
Great saphenous vein including saphenofemoral junction and throughout thigh at a minimum
Inferior to knee
Great saphenous vein - below the knee
Small saphenous vein
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 stand-alone color Doppler images
Internal jugular vein
Subclavian vein
Axillary vein
Brachial veins
Longitudinal spectral Doppler waveform with color Doppler evaluation
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
Longitudinal gray scale images
Common carotid artery – proximal and distal
Internal carotid artery – proximal
External carotid artery – proximal
Longitudinal stand-alone color Doppler images
Common carotid artery – proximal and distal
Internal carotid artery – proximal
External carotid artery – proximal
Longitudinal spectral Doppler waveform with color Doppler evaluation
Common carotid artery – proximal and distal
Internal carotid artery – proximal, mid, 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 documentation in longitudinal
At least three gray scale images of the left lobe to include lateral, mid, medial
At least three gray scale images of the right lobe to include lateral, mid, medial
Complete gray scale documentation in transverse
At least three gray scale images of the left lobe to include superior, mid, inferior
At least three gray scale images of the right lobe to include superior, mid, inferior
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 documentation in longitudinal
At least three gray scale images of the left lobe to include lateral, mid, medial
At least three gray scale images of the right lobe to include lateral, mid, medial
Complete gray scale documentation in transverse
At least three gray scale images of the left lobe to include superior, mid, inferior
At least three gray scale images of the right lobe to include superior, mid, inferior
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 documentation in longitudinal
At least three gray scale images of the left lobe to include lateral, mid, medial
At least three gray scale images of the right lobe to include lateral, mid, medial
Complete gray scale documentation in transverse
At least three gray scale images of the left lobe to include superior, mid, inferior
At least three gray scale images of the right lobe to include superior, mid, inferior
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
Both kidneys MUST be present
Complete gray scale documentation of kidneys in longitudinal
At least three gray scale images to include lateral, mid without measurement, medial
Complete gray scale documentation of kidneys in transverse
At least three gray scale images to include upper pole, mid without measurement, lower pole
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 three gray scale images to include lateral, mid without measurement, medial
Complete gray scale documentation of kidneys in transverse
At least three gray scale images to include upper pole, mid without measurement, lower pole
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 three gray scale images to include lateral, mid without measurement, medial
Complete gray scale documentation of kidneys in transverse
At least three gray scale images to include upper pole, mid without measurement, lower pole
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, distal
Right common iliac artery
Left common iliac artery
Transverse gray scale images without and with transverse measurements
Aorta – proximal, mid, distal
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, distal
Right common iliac vein
Left common iliac vein
Transverse gray scale images
Inferior vena cava – proximal, mid, distal
Bifurcation into proximal common iliac veins
Color and/or spectral Doppler waveform
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Exam Requirements: Vascular Ultrasound (Revised 5-10-2022) Print
Modified on: Tue, 10 May, 2022 at 2:20 PM
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