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Dopplerography of the arteries of the lower extremities
Last reviewed: 05.07.2025
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Diagnosis of peripheral arterial diseases of the extremities is based on clinical examination, including Ratcshow or Allen tests, pulse assessment, walking time, and measurement of the ankle-brachial index (ABI). Based on the results of these studies, indications for color duplex sonography of the arteries of the extremities are determined.
Traditionally, digital subtraction angiography has been considered the gold standard for diagnosing peripheral arterial occlusive disease. However, color duplex sonography of peripheral arteries is becoming an increasingly important noninvasive diagnostic technique.
The main indications for color duplex sonography, in addition to the assessment of peripheral arterial occlusive disease and widespread atherosclerosis, are quantitative assessment of the degree of stenosis in peripheral arterial occlusive disease, functional examination and monitoring after reconstructive surgeries (bypass anastomosis, endarterectomy, hemodialysis fistula). Color duplex sonography allows to reduce the frequency of diagnostic digital subtraction angiography before interventional and surgical interventions on vessels. Therapeutic applications of color duplex sonography include compression therapy of pseudoaneurysms, which allows to reduce the number of vascular surgical interventions.
Methodology for examining arteries of the lower limb
The examination always begins with visualization of the pelvic arteries. Several zones have been identified, the examination of which allows differentiation of physiological and pathological changes. Therefore, there is no need to examine the entire lower limb.
Methodology for examining arteries of the upper and lower limbs
Picture of normal blood flow at rest
After identifying the vessels in B-mode, examine them in color duplex sonography mode in the longitudinal axis and, if necessary, in the transverse axis. The color mode is initially used only in the shin and forearm area, since it allows you to determine the localization and course of the vessels. Select the pulse repetition frequency before measuring the blood flow velocity.
Normal blood flow in the arteries of the lower limb
Color duplex sonography in the diagnosis of peripheral arterial disease
Peripheral arterial occlusive disease (PAOD)
Peripheral arterial occlusive disease caused by atherosclerosis is the most common disease of the arteries of the extremities (95%). Color duplex sonography can be used for screening patients with clinical suspicion of OBPA and for monitoring after surgical treatment. About 10% of the population has peripheral circulation disorders, of which 10% have affected arteries of the upper limb, and 90% - of the lower limb (35% - pelvis, 55% leg). Often there is damage at several levels and bilateral disease. The earliest ultrasound sign of clinically hidden atherosclerosis is thickening of the intima and media.
Ultrasound signs of peripheral arterial disease
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