Noninvasive vascular laboratory in clinical practice.
Noninvasive vascular testing methods have validated application in the evaluation of patients with suspected peripheral arterial, cerebrovascular, or peripheral venous disease.  Accurate and reproducible testing requires the use of appropriate instrumentation by experienced technologists, and interpretation of data with verified diagnostic criteria.  Noninvasive testing can facilitate clinical decision-making by providing quantitative anatomical and hemodynamic data, thereby quantifying functional severity of disease.  Duplex ultrasonography is essential instrumentation for cerebrovascular testing to localize and grade occlusive lesions.  In peripheral arterial testing, the combination of segmental pressure measurements and waveform (velocity, pulse pressure) analysis should be the initial diagnostic method, with duplex scanning reserved for characterizing hemodynamically abnormal arterial segments.  A number of techniques (duplex scanning, B-mode imaging supplemented by Doppler, venous outflow plethysmography) are appropriate for assessing the venous system for thrombosis, structural abnormalities, and venous valve function. Physicians should be aware of the pitfalls of noninvasive vascular testing and confirm equivocal studies using "gold standard" diagnostic methods such as arteriography and contrast venography.
Vascular Surgery Section, University of South Florida College of Medicine, Tampa.
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D000465:Algorithms; D001808:Blood Vessels / Q000000981:diagnostic imaging*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler / Q000379:methods* / Q000592:standards; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D011785:Quality Assurance, Health Care; D014481:United States