Thursday, February 1, 2024

Normal Aortic Bifurcation into Common Iliac Arteries in Adults, color Doppler


# Normal Aortic Bifurcation into Common Iliac Arteries in Adults, color Doppler 

In the context of the aortic bifurcation, a normal color Doppler US examination should reveal the following:

**Aortic Bifurcation:

* Location: The aortic bifurcation typically occurs at the level of the L4 vertebra, dividing into the left and right common iliac arteries.

* Diameter: The normal diameter of the aorta at the bifurcation ranges from 1.8 to 2.5 cm, and the common iliac arteries measure approximately 8-12 mm in diameter.

* Flow pattern:** Bipedal US evaluation demonstrates continuous, biphasic flow with a dominant systolic peak and a smaller diastolic peak in both common iliac arteries.

* Spectral waveforms: The spectral waveforms should be smooth and symmetrical, with peak systolic velocity (PSV) typically ranging from 50-90 cm/s and an end-diastolic velocity (EDV) of 20-30 cm/s. The resistive index (RI) is calculated as (PSV-EDV)/PSV and should be less than 0.7.

* Color flow: Color flow imaging should demonstrate antegrade flow within the common iliac arteries and their branches, with no evidence of turbulence, aliasing, or flow reversal.

* Intimal lining:The intimal lining of the aorta and common iliac arteries should appear smooth and echogenic with no focal wall thickening or plaques.

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*Major Branches of the Abdominal Aorta:

The abdominal aorta gives rise to several important branches that supply blood to the abdominal organs and lower extremities. Color Doppler US can assess these branches for patency, flow characteristics, and potential abnormalities. Here's a brief overview of the major branches:

* Celiac artery: Originates just above the diaphragm and supplies blood to the stomach, spleen, liver, and upper duodenum. Normal PSV ranges from 40-70 cm/s, and RI should be less than 0.75.

* Superior mesenteric artery (SMA): Arises below the celiac artery and supplies blood to the small intestine, pancreas, and colon. Normal PSV ranges from 50-80 cm/s, and RI should be less than 0.7.
* Renal arteries: These paired arteries arise just above the SMA and supply blood to the kidneys. Normal PSV ranges from 50-90 cm/s, and RI should be less than 0.8.

* Inferior mesenteric artery (IMA): Originates below the renal arteries and supplies blood to the descending colon and rectum. Normal PSV ranges from 30-60 cm/s.

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