Vascular Ultrasound

Vascular disease has many diverse presentations and the diagnosis and management of the disease process is a multifaceted issue. Ulceration is a typical example of a complex and insidious problem where the underlying disease process may be venogenic, arteriogenic, or a combination of both. When investigating vascular disease, high-resolution ultrasound imaging is invaluable, although it is inadequate if used as a stand-alone diagnostic tool. Ultrasound cannot provide a complete picture of vascular pathophysiology and for this functional studies are essential. A specialist Vascular Ultrasound facility utilises the latest ultrasound technology including Colour Duplex Ultrasound (CDU), Brightness-Flow (B-Flow) Imaging and 3-D imaging. Functional assessments are performed using Infrared Photoplethysmography and Spectral Analysis of Pulsed and Continuous Wave Doppler velocity waveforms and arterial pressure measurements, both before and after exercise stress testing.

Time has shown that Vascular ultrasound examinations should be performed and interpreted by experienced personnel trained in the diagnosis and management of vascular disease. There are several reasons why specialisation is critical.

• Recognising normal and anomalous anatomy is an art itself, particularly where venous disease is concerned.
• Determining the location, extent and clinical significance of vascular pathology is the next big hurdle to overcome.
• The Ankle-Brachial Pressure Indexlity to vary the examination as appropriate can be the difference between a correct diagnosis and a useless examination.
• This type of investigation is very much "operator-dependent" and is best undertaken by sonographers who perform these tests on a regular basis. Our Vascular Technologists have many years of vascular experience and are accredited with the Diploma of Medical Ultrasound (Vascular). All are registered with the Australian Sonographers Association.
• Correct interpretation of data is dependent on a comprehensive understanding of vascular anatomy and pathophysiology. An awareness of the implications of findings and the instigation of appropriate management is also important and this expertise commonly is not available outside of the specialist vascular laboratory setting.
• Recent data collected by Medicare reveals that vascular ultrasound examinations performed in General Radiology practices were grossly inadequate. When patients were subsequently sent for a surgical consultation, a staggering 80% of these examinations were deemed inadequate and were repeated in a specialised vascular laboratory.

We aim to provide a comprehensive and specialised vascular diagnostic service to assist physicians in making a timely clinical diagnosis. We have Vascular Surgeons accredited with the Diploma of Diagnostic Ultrasound or who have a recognised Vascular Fellowship in diagnostic ultrasound either onsite or on-call who can interpret the examinations and their significance as well as instigate immediate treatment. We can arrange further appropriate investigations and have access to specialist care in a vascular orientated private or public hospital.