Duplex ultrasound

  • Definition
    • A duplex ultrasound is a test to see how blood moves through your arteries and veins.

  • Alternative Names
    • Vascular ultrasound; Peripheral vascular ultrasound

  • How the Test is Performed
    • A duplex ultrasound combines:

      • Traditional ultrasound: This uses sound waves that bounce off blood vessels to create pictures.
      • Doppler ultrasound: This records sound waves reflecting off moving objects, such as blood, to measure their speed and other aspects of how they flow.

      There are different types of duplex ultrasound exams. Some include:

      • Arterial and venous duplex ultrasound of the abdomen. This test examines blood vessels and blood flow in the abdominal area.
      • Carotid duplex ultrasound looks at the carotid artery in the neck.
      • Duplex ultrasound of the extremities looks at the arms or legs.
      • Renal duplex ultrasound examines the kidneys and their blood vessels.

      You may need to wear a medical gown. You will lie down on a table, and the ultrasound technician will spread a gel over the area being tested. The gel helps the sound waves get into your tissues.

      A wand, called a transducer, is moved over the area being tested. This wand sends out the sound waves. A computer measures how the sound waves reflect back, and changes the sound waves into pictures. The Doppler creates a "swishing" sound, which is the sound of your blood moving through the arteries and veins.

      You need to stay still during the exam. You may be asked to lie in different body positions, or to take a deep breath and hold it.

      Sometimes during a duplex ultrasound of the legs, the health care provider may calculate an ankle-brachial (ABI) index. You will need to wear blood pressure cuffs on your arms and legs for this test.

      The ABI number is obtained by dividing the blood pressure in the ankle by the blood pressure in the arm. A value of 0.9 or greater is normal.

  • How to Prepare for the Test
    • Usually, there is no preparation for this test.

      If you are having an ultrasound of your stomach area, you may be asked not to eat or drink after midnight. Tell the person doing the ultrasound exam if you are taking any medicines, such as blood thinners. These might affect the results of the test.

  • How the Test will Feel
    • You may feel some pressure as the wand is moved over the body, but there is no discomfort most of the time.

  • Why the Test is Performed
  • Normal Results
    • A normal result is normal blood flow through the veins and arteries. There is normal blood pressure and no sign of a narrowing or blockage of a blood vessel.

  • What Abnormal Results Mean
    • An abnormal result depends on the specific area being examined. An abnormal result may be due to a blood clot or plaque buildup in a blood vessel.

  • Risks
    • There are no risks.

  • Considerations
    • Smoking may change the results of an ultrasound of the arms and legs. This happens because nicotine can cause the arteries to shrink (constrict).

  • References
    • Goldstein LB. Approach to cerebrovascular diseases. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 406.

      Leon LR, Labropoulos N. Vascular laboratory. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 18.

      Stone PA, Hass SM. Vascular laboratory. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 16.