Ecografie — Artere mezenterice (MCB)

Mesenteric Artery US Protocol

PURPOSE:

 To evaluate the mesenteric arteries for hemodynamically significant stenosis.

INDICATIONS:

 Evaluation of patients with postprandial pain, weight loss, nausea, vomiting and diarrhea or those patients only able to eat small meals.

EQUIPMENT:

 3-5 MHz linear or curved probe

PATIENT PREPARATION & ASSESSMENT:

 The patient should be NPO after midnight or 6-8 hours prior to examination.  Introduce yourself to the patient.
 Verify patient identity via two patient identifiers (name and date of birth) per hospital policy.  Explain the examination, its purpose and how long it will take.  Answer any questions the patient may have regarding the examination.  Obtain patient history including symptoms, signs, risk factors and other relevant history.

GENERAL GUIDELINES:

 Optimize equipment gain and display settings with respect to depth, dynamic range and focal zones while imaging vessels.  Add color Doppler to supplement grayscale images with proper color scale to demonstrate areas of high flow and color aliasing.  Use power Doppler to validate low flow states or occlusions.  Set spectral Doppler gains to allow a spectral window and optimized to reduce artifacts.  Cursor sample size will be small and positioned parallel to the vessel wall and/or direction of blood flow.  A spectral Doppler angle of 45-60 degrees or less will be used to measure velocities. Note exceptions to these angles on the technologist worksheet.  Send the measurements screenshot page if your machine is capable.  Any deviations from the standard protocol and any limitations to the examination should be documented on the technologist worksheet for future reference and for repeatability in follow-up studies.  Report preliminary critical findings to the referring clinician when appropriate (i.e. immediate medical attention may be warranted) and according to hospital policy.  Use Cerner order US Abdomen Art/Venous Duplex Limited.

Mesenteric Artery Protocol – Last Updated 3/31/2024 - Page 1 of 2

DOCUMENTATION:

Celiac Artery  Document longitudinal images of the proximal aspect of the celiac artery.  Document longitudinal color Doppler images of the proximal aspect of the celiac artery.  Document longitudinal spectral Doppler images of the proximal aspect of the celiac artery with PSV measurements of the following:  Supine at end inspiration  Supine at end expiration  Standing at end inspiration

Superior Mesenteric Artery  Document longitudinal images of the proximal aspect of the superior mesenteric artery.  Document longitudinal color Doppler images of the proximal aspect of the superior mesenteric artery.  Document longitudinal spectral Doppler images of the proximal aspect of the superior mesenteric artery with PSV measurement.

Inferior Mesenteric Artery  Document longitudinal images of the proximal aspect of the inferior mesenteric artery.  Document longitudinal color Doppler images of the proximal aspect of the inferior mesenteric artery.  Document longitudinal spectral Doppler images of the proximal aspect of the inferior mesenteric artery with PSV measurement.

Abdominal Aorta  Document longitudinal images of the proximal aspect of the abdominal aorta.  Document longitudinal color Doppler images of the proximal aspect of the abdominal aorta.  Document longitudinal spectral Doppler images of the proximal aspect of the abdominal aorta with PSV measurement.

DISEASE GRADING:

 Findings of >70% Celiac Artery Stenosis: PSV > 200 cm/sec.  Findings of >70% SMA Stenosis: PSV > 275 cm/sec or EDV > 45 cm/sec.  Findings of >70% IMA Stenosis: PSV > 200 cm/sec.  Findings of Median Arcuate Ligament Syndrome: celiac PSV is lower in either supine end inspiration or standing end inspiration compared with supine end expiration.  PSV in the celiac and superior mesenteric arteries will increase by at least 20% in normal patients following a meal.

Mesenteric Artery Protocol – Last Updated 3/31/2024 - Page 2 of 2