90347 - Introduction to the Vascular Doppler Test

Learning outcomes

The course aims to provide the student a knowledge base of physics and technology principles in performing Doppler ultrasound examination. Hence by the end of the course the student will be able to use the right probe combination suitable for the Doppler study of various abdominal districts and so will be familiar with the principal functions that need specific regulation to perform such an exam. Besides, the course is aimed to illustrate the regular Doppler patterns and the principal diagnostic elements of different pathological scenarios of either vascular, parenchymal or neoplastic lesions. In particular, the student will be able to have practical understanding of which probable finding might be obtained from a given Doppler examination of every anatomical section in the program below, and also to request Doppler exam in an appropriate way with adequate clinical query.

Course contents

For the academic year of 2008/09 the course will be held in February, on Tuesday the 24th, from 9 a.m.to 6 p.m. at the Aula Magna auditorium of the Nuove Patologie building (PAD. 5). The definitive day in which the course will be given and the attendance sheet will be posted from October at the notice board in front of the Secretary Office of Internal Medicine Prof. Bolondi which is found on the third floor of the Malpighi building (PAD. 2). The course shall be considered completed, with relative credits, only for those who will follow the whole course (attendance check will be made at any time from 9 a.m to 6 p.m) and will pass the final test.

Program
Physics and technology principles of Doppler Ultrasound.
Hemodynamic principles
Performing Doppler Ultrasound
Venous Doppler Ultrasound of the lower extremity: anatomy of the veins of the lower extremity, venous trombosis detection(determining of the presence of ), venous valvular system assessment .
Arterial Doppler Ultrasound of lower extremity: anatomy of the arterial circulation, criteria for the diagnosis of occlusions and stenoses, hemodynamic alterations distal (downstream) and proximal (up stream) to the obstructing lesion.
Cervical Carotid and vertebral Doppler Ultrasound: anatomy of the extracranial cerebrovascular circulation, blood flow features of various districts, the ultrasound patter and pathologic correlation of the plaque, criterion for the detection and (grading) determination of severity of the stenoses or obstruction.
Doppler Ultrasound of the thyroid gland: characterization of the overall diffuse tissue alteration and of the focal lesions using Color Doppler vascular features.
Doppler Ultrasound of patients with portal hypertension: portal thrombosis, direction of the blood flow and alterations of the quantitavie and semi quantitative parameters of the portal circulation and of the arterial –splenic and mesenteric- circulation as well in the presence of portal hypertension.
Doppler Ultrasound in renal disorders and nephrovascular hypertension: renal arterial anatomy, hemodynamic alteration patterns in correspondence of the obstruction, and up and down stream of the stenosis (parvus tardus waveform).
Doppler Ultrasound evaluation of abdominal aortic-iliac and mesenteric artery pathologies: ultrasonic anatomy, ultrasonic description of the aneurism, stenosis diagnosis and grading criteria.

Readings/Bibliography

In order to take the exam it will be sufficient to attend the regular lecture classes. For those interested, additional material could be consulted on:
- Eco-color - doppler vascolare, III edizione, Curatori: Rabbia - De Lucchi - Cirillo
Minerva Medica
- Peripheral Vascular Ultrasound, 2nd edition. How, Why and When By Abigail Thrush and Timothy Hartshorne, Churchill Livingstone
- Ecografia Clinica, Curatori Busilacchi - Rapaccini, Editore Idelson-Gnocchi

Teaching methods

Lectures with video projection. Demonstration of Doppler Ultrasound in healthy volunteers at the lecture spot

Assessment methods

Individual multichoice questions will have to be answered at the end of the course

Teaching tools

The large majority of the slides to be presented during the course will be made available  online before the date of the course.

Office hours

See the website of Fabio Piscaglia