clinical indications us - ucsf cme beel aorta.pdfrenal cyst 3/30/2016 14 renal mass emphysematous...
TRANSCRIPT
![Page 1: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/1.jpg)
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US of the AortaRenal US
Brett Beel MD, RDMS
Clinical Instructor, UCSF Fresno Department of Emergency Medicine
Clinical Indications
• “There is no disease more conducive to clinical humility than the aneurysm of the aorta.”
‐‐William Osler
• Prevalence: 2‐5% in population >50yoa, 10% of men >65 with vascular risk factors
Clinical Indications
• Ruptured AAA has wide clinical presentation
• Patients >50 yoa with abdominal pain, flank pain, back pain, testicular pain, constipation
• Syncope, hypotension
Clinical Indications
• <25% ruptured AAA have classic triad of abdominal/back/flank pain, palpable abdominal mass and hypotension
• 30‐60% of ruptured AAA are misdiagnosed upon initial presentation
• Mortality for ruptured AAA is 80%
![Page 2: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/2.jpg)
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Ultrasound Nuts/Bolts Sonographic Views
• Transverse Umbilical
• Transverse Subxiphoid
• Longitudinal
• Bifurcation into the iliac arteries
Transverse UmbilicalSubxiphoid
TransverseUmbilical
![Page 3: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/3.jpg)
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Transverse Subxiphoid
Transverse Umbilical
TransverseSubxiphoid
![Page 4: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/4.jpg)
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LongitudinalLongitudinal
Longitudinal
Longitudinal
Bifurcation into Iliacs
![Page 5: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/5.jpg)
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AAA = >3 cm AAA risk of rupture per year
• AAA 3‐4cm: 2%
• AAA 4‐5cm: 1‐5%
• AAA 5‐6 cm: 3‐15%
• AAA 6‐7cm: 10‐20%
• AAA>7cm: 20‐50%
![Page 6: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/6.jpg)
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Caveats
• Adventitia to Adventitia measurements
• Cylinder Tangent Error
![Page 7: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/7.jpg)
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Questions? Renal/Bladder US
Clinical Indications
• Determination of presence/degree of hydronephrosis
• Detection of UVJ stones
• Bladder volume
• Incidental findings
Ultrasound Nuts/Bolts
![Page 8: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/8.jpg)
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Sonographic Views
• Long/Short Axis View of each kidney
• Bladder transverse/sagittal views of bladder
Long Axis
Long Axis
![Page 9: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/9.jpg)
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Short Axis Short Axis
Bladder Transverse Bladder Transverse
![Page 10: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/10.jpg)
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Bladder Sagittal
Bladder Sagittal
![Page 11: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/11.jpg)
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Hydronephrosis
![Page 12: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/12.jpg)
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UVJ Stone
Bladder Volume
• Height (cm) x Width (cm) x Depth (cm) x 0.7
• = bladder volume in mL
![Page 13: Clinical Indications US - UCSF CME Beel Aorta.pdfRenal Cyst 3/30/2016 14 Renal Mass Emphysematous Pyelonephritis Questions? Title Microsoft PowerPoint - Beel Aorta.pptx Author GraysonK](https://reader035.vdocuments.mx/reader035/viewer/2022071605/614188a8a2f84929c304722c/html5/thumbnails/13.jpg)
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Renal Cyst
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Renal Mass Emphysematous Pyelonephritis
Questions?