This is a case of a female patient that was diagnosed with an isolated deep vein thrombosis of the right popliteal vein. The patient attended a 6 month follow up ultrasound scan that revealed complete re-canalisation of the popliteal vein and evidence of deep venous reflux. Venous reflux can be diagnosed using either colour flow Doppler and pulsed wave Doppler. As shown in the video, using a provocation manoeuvre (calf compression in this case), it is possible to visualise retrograde venous flow after calf release.

When using colour flow Doppler, attention must be paid to the colour scale setting as venous reflux will appear with the same colour represented on the top (towards the probe) of the colour scale bar.

Pulsed wave Doppler is used to confirm the presence of venous reflux and to evaluate its length: 1 second is the cut off value used for defining the presence of deep venous reflux.

TAKE HOME MESSAGE: Colour flow Doppler and pulsed wave Doppler are both useful in diagnosing the presence of venous reflux.

Videos provided courtesy of ABC Vascular.