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Pulsatile masses surrounding vascular prostheses: real-time US color flow imaging
J F Polak1, M C Donaldson, A D Whittemore
1Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.
Radiology
|February 1, 1989
Summary
Color Doppler ultrasound effectively distinguishes pseudoaneurysms from other masses around vascular grafts. This imaging technique identifies characteristic swirling blood flow, aiding diagnosis of prosthetic graft complications.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Medical Ultrasound
Background:
- Pulsatile masses near vascular grafts require accurate differentiation.
- Distinguishing pseudoaneurysms from hematomas or infections is crucial for patient management.
Purpose of the Study:
- To evaluate color flow mapping and real-time ultrasound for differentiating pseudoaneurysms from other masses surrounding lower extremity vascular grafts.
- To assess the diagnostic accuracy of ultrasound in identifying prosthetic graft pseudoaneurysms.
Main Methods:
- Prospective evaluation of twelve palpable pulsatile masses around vascular grafts.
- Utilized color flow mapping and real-time ultrasound.
- Confirmed diagnoses with angiography, CT, aspiration biopsy, and surgery.
Main Results:
- Swirling blood flow patterns were observed in six of seven pseudoaneurysm cases.
- Absence of flow signals correctly identified hematoma or infection in four cases.
- A specific swirling flow pattern from a wide neck distinguished prosthetic graft pseudoaneurysms.
Conclusions:
- Color Doppler flow imaging is valuable for the differential diagnosis of pulsatile masses associated with prosthetic grafts.
- Ultrasound can reliably differentiate prosthetic graft pseudoaneurysms from other perigraft masses.