For optimal Doppler velocity measurement during carotid duplex imaging, the angle between the ultrasound beam and the direction of blood flow should be:
Ultrasound Physics
Question · Easy
A sonographer scanning a deep abdominal vessel needs to balance penetration with resolution. Which transducer frequency is most appropriate for an aortic duplex on an average-sized adult?
Introduction & Exam Overview
1.1 About the CCI RVS Exam
Study guide
Aliasing on color Doppler imaging occurs when:
Question · Medium
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Which adjustment will MOST effectively reduce aliasing during a renal artery Doppler exam when peak velocities exceed the displayed scale?
Tissue harmonic imaging improves image quality primarily by:
The spectral Doppler sample volume (gate) for measuring peak systolic velocity in the internal carotid artery should be:
1.2 How to Prepare for the RVS Exam
During a peripheral arterial duplex, the sonographer notices excessive color bleed into surrounding tissue and the color box overflowing the lumen. The MOST appropriate first correction is to:
In the Doppler equation, which variable is squared and therefore has the greatest effect on Doppler shift error from misalignment?
Question · Hard
Power (energy) Doppler differs from color Doppler in that power Doppler:
Spectral broadening on a carotid Doppler waveform is BEST described as:
Principles of Ultrasound Physics & Transducer Technology
2.1 Ultrasound Waves, Propagation Speed & Attenuation
Which feature on duplex BEST distinguishes the external carotid artery (ECA) from the internal carotid artery (ICA)?
Carotid Duplex
A normal internal carotid artery (ICA) waveform demonstrates:
Per the Society of Radiologists in Ultrasound (SRU) Consensus Conference (2003) criteria, an ICA peak systolic velocity (PSV) of 240 cm/s with an ICA/CCA ratio of 4.5 and visible plaque most likely indicates:
Per SRU consensus criteria, the ICA peak systolic velocity threshold for greater than 50% stenosis is:
2.2 Transducer Selection & Beam Formation
An ICA/CCA peak systolic velocity ratio greater than 4 most likely indicates:
Reversed flow in the right vertebral artery during a duplex exam, in a patient with a weak right radial pulse, is MOST consistent with:
Which plaque characteristic on carotid duplex is MOST associated with embolic risk?
A patient has a CCA peak systolic velocity of 50 cm/s on the right and 110 cm/s on the left, with a normal-appearing left ICA. The MOST likely explanation is:
2.3 Grayscale Instrumentation & B-Mode Optimization
The CCI RVS credential differs from the CCI RPhS in that:
Professional Quality
During carotid duplex, a sudden absence of diastolic flow in the ICA with a thumping high-resistance waveform suggests:
A normal ankle-brachial index (ABI) value range is:
Peripheral Arterial Lower
A patient with diabetes has an ABI of 1.45 with monophasic Doppler waveforms at the ankle. The MOST appropriate next test is:
Hemodynamics & Doppler Waveform Analysis
3.1 Hemodynamics & Fluid Energy Principles
During lower-extremity arterial duplex, a velocity ratio (V2/V1) of 2.5 or greater across a focal lesion indicates approximately:
A normal triphasic peripheral arterial Doppler waveform consists of:
Segmental pressure measurement during arterial physiologic testing demonstrates a 25 mmHg drop from the high thigh to the above-knee thigh on the right. This is MOST consistent with:
A pulsatile groin mass with characteristic 'yin-yang' color Doppler appearance and to-and-fro flow at the neck on spectral Doppler post-cardiac catheterization is MOST consistent with:
Aneurysm Pseudoaneurysm
3.2 The Doppler Equation & Spectral Optimization
Allen test or Barbeau (pulse oximetry) testing is typically performed to evaluate:
Peripheral Arterial Upper
Positional duplex (with arm hyperabduction and external rotation) is used to evaluate which condition?
Per the Rutherford classification of chronic limb ischemia, category 4 represents:
In CLTI evaluation, an ankle pressure of 35 mmHg with toe pressure of 25 mmHg is consistent with:
3.3 Spectral Waveform & Color Flow Analysis
The single MOST important duplex finding for the diagnosis of acute lower-extremity deep vein thrombosis (DVT) is:
Venous Lower Extremity
On lower-extremity venous duplex, an enlarged dilated vein with echogenic material that does not compress is MOST suggestive of:
In an isolated calf vein thrombus involving the soleal vein only, the most appropriate next step per most current guidelines includes:
May-Thurner syndrome refers to:
Extracranial Carotid Duplex Evaluation
4.1 Extracranial Cerebrovascular Anatomy & Protocol
For diagnosing reflux on venous duplex of the lower extremity in the standing or reverse-Trendelenburg position, abnormal reflux duration in deep veins is:
In CEAP classification, C3 represents:
The USPSTF gives a Grade B recommendation for one-time AAA screening in:
Abdominal Vascular
Per SVS guidelines, the typical surgical-repair size threshold for an asymptomatic infrarenal abdominal aortic aneurysm in men is:
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