Spectrum of Findings in Lower Limb Doppler Ultrasonography in UBTH, Benin City

Authors

  • Ehigiamusoe FO Department of Radiology, College of Medicine, University of Benin, Benin City. https://orcid.org/0000-0002-9655-7836
  • Emilomon JO Department of Radiology, University of Benin Teaching Hospital, Benin City

DOI:

https://doi.org/10.4314/ajtmbr.v6i2.4

Keywords:

lower limb, doppler, ultrasonography, spectrum

Abstract

Objectives: Doppler ultrasonography (USS) is a relatively new radiological procedure in our environment but gradually gaining recognition in assessment of lower limb pathologies. This study aims to assess the pattern of referrals for lower limb Doppler USS and the outcome of the procedure at the University of Benin teaching hospital

Materials and Methods: This was a retrospective study carried out at the University of Benin teaching hospital, between January 2018 and June 2019. The request forms and Doppler scan results of patients done within this period were retrieved and relevant information were obtained and analyzed using statistical package for social sciences, version 23.

Results: A total of 204 patients comprising of 125 females (61.3%) and 79 males (38.7%) were analyzed in this study. Mean age of study population was 55.25±17.02 years. The commonest indication for lower limb Doppler scan was leg swelling (70, 22.8%) while the least was peripheral arterial disease (PAD) (14, 4.6%)

The commonest Doppler ultrasound finding was PAD (74, 44.3%), followed by DVT (39, 23.4%). The least findings on Doppler ultrasound of the lower limb were arterio-venous malformation (AV) malformation (1, 0.6%). Arterial wall calcification (100%) was the commonest Doppler finding in patients with PAD. DVT occurred more in the left lower limb (67.7%) than right limb (32.3%) and superficial femoral vein (27.8%) was most affected.

Conclusion: This study has shown that Doppler scan is quite relevant in lower limb pathologies and peripheral artery disease is the commonest diagnosis in the lower limb.

References

Myron A., Paul L. Clinical Doppler Ultrasound. 3rd edition. Edinburgh: Churchill Livingstone; 2014. Pages 94-121.

Verim S, Tasci I. Doppler ultrasonography in lower extremity peripheral arterial disease. Arch Turk Soc Cardiol 2013;41 (3):248-255.

Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss LK, et al. 2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients with Peripheral Artery Disease (updating the 2005 guideline): a report of the American College of Cardiolog y Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2011; 58:2020-45.

Hwang JY. Doppler ultrasonography of the lower extremity arteries: anatomy and scanning guidelines. 36(2): 111-119. Ultrasonography. 2017;

Ibrahim MZ, Igashi JB, Lawal S, Usman B, Mubarak AZ, Suleiman HM. Doppler ultrasonographic evaluation of lower limbs deep-vein thrombosis in a teaching hospital, Northwestern Nigeria. Ann Afr Med 2020;19:8-14.

Misauno M A, Sule A Z, Pam S D, Ideke SC, Aching G I. Pattern of duplex doppler ultrasound scans in Jos University Teaching Hospital. Niger J Med.2009;18 (2):158-61.

Ikhlas O.S., Ibrahim A.A. Value of Doppler ultrasound in Diagnosis of Clinically suspected Deep vein Thrombosis. IJDMSR 2018; 2(1):01-06.

Swaroopa P., Murali K.G. Effectiveness of D- Dimer as a Screening Test for Venous Thromboembolism: An Update. N Am J Med Sci 2014; 6(10): 491-499.

Zemaitis MR, Boll JM, Dreyer MA. Peripheral Arterial Disease. [Updated 2023 May 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430745/

Akpan IS, Enabulele O, Adewole AJ. An overview of peripheral artery disease in the elderly: A study in a tertiary hospital Southern Nigeria. Niger Med J 2020;61:1-5

Anas I., Muhammed K.S., Abdulkadir M.T., Kabiru I. Clinical and doppler ultrasound evaluation of peripheral arterial diseases in Kano, North-westwern Nigeria. Niger Postgrad Med J 2015; 22 (4):217-222.

Ikpeme A., Akintomide A., Ukweh O., Effanga S. Duplex ultrasound: Indications and findings in a newly created facility at the University of Calabar Teaching Hospital, Calabar. Niger J Clin Pract 2016; 19(3):339- 343.

Igbinedion B.O., Ogbeide O.U. Utilization pattern of Doppler ultrasound scan at the University of Benin Teaching Hospital. West Afri J Radiol 2015; 22(1): 15-19.

Linus U. Nigeria: Meet the Female Bikers Promoting Health Awareness Among Nigerian Women. https://allafrica.com/ stories/20182200689.html. Published in 2018

Verdonk P, Benschop YWM, De Haes, HCJM et al. From gender bias to gender awareness in medical education. Adv in Health Sci Educ 2009;14:135.

Tiwari A, Cheng K, Button M, Myint F, Hamilton G. Differential Diagnosis, Investigation, and Current Treatment of Lower Limb Lymphedema. Arch Surg. 2003;138 (2):152-161.

Li L, Zhen J, Huang L, Zhou J, Yao L, Xu L, et al. The risk factors for deep venous thrombosis in critically ill older adult patients: a subgroup analysis of a prospective, multicenter, observational study. BMC Geriatr 22, 977 (2022).

https://doi.org/10.1186/s12877-022- 03599-y.

Miller AP, Huff CM, Roubin GS. Vascular disease in the older adult. J Geriatr Cardiol. 2016;

(9):727-732.

Savji N, Rockman C B, Skolnick A H, Guo Y, Adelman M A, Riles T, et al. Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects. J Am Coll Cardiol, 61 (2013), pp. 1736-1743.

Mary MM, Jack MG, Luigi F, Lu T, Kiang L, Yihua L et al. Asymptomatic Peripheral Arterial Disease Is Associated With More Adverse Lower Extremity Characteristics Than Intermittent Claudication. J. Am. Heart Assoc 2008; 117 (19): 2484 – 2491.

Hiremath R, Gowda. G, Ibrahim J, Reddy H T, Chodiboina H, et al. Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system. Ultrasonography 2017; 36:270-277.

Virchow R. Ueber die Erweiterung kleinerer Gefa¨fse. Arch Pathol Anat Physiol Klin Med 1851; 3: 427–62.

Thijs W, Rabe KF, Rosendaal FR, Middeldorp S. Predominance of left-sided deep vein thrombosis and body weight. J Thromb Haemost 2010; 8: 2083–4.

Jeanette M, Nicolaides AN, Walker CJ, O'Connell JD. Value of Doppler ultrasound in diagnosis of clinically suspected deep vein thrombosis. BMJ. 1975; 4: 552-554.

Goodacre S, Sampson F, Thomas S, Van Beek E, Sutton A. Systematic review and meta-analysis of

the diagnostic accuracy of ultrasonography for deep vein thrombosis. BMC Med Imaging. 2005 Oct 3; 5:6.

National Clinical Guideline Centre (UK). Diagnosis of Deep Vein Thrombosis. Venous Thromboembolic Diseases: The Management of Venous Thromboembolic Diseases and the Role of Thrombophilia Testing (Internet). London: Royal College of Physicians (UK); 2012; 144:5.

Francis F, Ahmed A. Varicose veins https://radiopaedia.org/article/varicose-veins?lang=us. Last reviewed 2017.

Irodi A, Keshava SN, Agarwal S, Korah IP, Sadhu D. Ultrasound Doppler Evaluation of the Pattern of Involvement Varicose Vein in Indian Patients. Indian J Surg. 2011; 73(2):125-130.

Downloads

Published

25-03-2024

How to Cite

1.
EHIGIAMUSOE F, Omua Emilomo John. Spectrum of Findings in Lower Limb Doppler Ultrasonography in UBTH, Benin City. AJTMBR [Internet]. 2024 Mar. 25 [cited 2024 Apr. 27];6(2):35-44. Available from: https://www.ajtmbr.org.ng/index.php/home/article/view/85