PMC3305527_01
Non-compressible vein (dual frame). Dual-frame image of the left femoral vein (lcfv) and artery (lcfa) in a 31-year old woman (case study A). The lcfv is non-compressible (long arrow) suggestive of acute deep vein thrombosis (DVT). Note the enhanced echo pattern in the soft tissue caused by oedema and the absence of post-acoustic shadow (small arrow).
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F5
Ultrasound scan revealed a non-compressible left FV at the injecting site (Figure 5) suggestive of acute DVT with extension of the blood clot to the FV in the middle third of the thigh (Figure 6).
Non-compressible vein (B mode). B-mode image of a non-compressible left femoral vein (lsfv, see arrow) behind the femoral artery (lsfa) in the thigh of the patient in figure 5 (case study A), indicative of extension of the blood clot to the femoral vein in the mid-thigh.
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F6
Ultrasound scan revealed a non-compressible left FV at the injecting site (Figure 5) suggestive of acute DVT with extension of the blood clot to the FV in the middle third of the thigh (Figure 6).
PMC3305527_02
Vein with minimal damage (grade 1). B-mode image of the left femoral vein (lcfv) and artery (lcfa) in a 30-year old groin injector (case study B). The damage to this vein is minimal (grade 1).
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F1
Ultrasound scan showed a normal-sized, fully compressible FV (Figure 1) with normal venous flow rate and pattern.
Normal venous flow (grade 1). Duplex scan showing normal blood flow - colour flow (top half) and spectral tracing (lower half) in the left femoral vein (lcfv) of the patient in figure 1 (case study B). Note the normal, phasic venous flow with respiration (arrows).
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F2
The 'phasic' flow pattern in Figure 2 indicates absence of outflow obstruction from the vein.
PMC3305527_03
Vein with moderate damage (grade 2). Dual-frame image and compression test in a 36-year old man (case study C). A sinus (short arrows) is seen above the right femoral vein (rcfv) which is not fully compressible (long arrow). This vein damage was graded as moderate (grade 2).
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F7
The dual image in Figure 7 demonstrates a depressed scar (sinus) at the injecting site with satisfactory blood flow through the FV (Figure 8).
Venous flow with minor abnormality (grade 2). Colour flow image from the right femoral vein (rcfv) of the patient in figure 7 (case study C). Note that venous blood flow (as indicated in colour flow image) beneath the sinus remains satisfactory (arrow).
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F8
The dual image in Figure 7 demonstrates a depressed scar (sinus) at the injecting site with satisfactory blood flow through the FV (Figure 8).
PMC3305527_04
Vein with severe damage (grade 3). Dual-frame image and compression test in a 43-year old woman (case study D). The left femoral vein (lcfv, short arrow) is smaller than the artery (lcfa) and the vein did not collapse completely with compression (long arrow). The damage to this vein was graded as severe (grade 3).
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F9
The FV is much smaller than the artery (Figure 9) with reduced blood flow and a 'continuous' flow pattern (Figure 10) indicating partial outflow obstruction.
Vein with reduced, continuous flow (grade 3). Duplex scan showing significant reduction in blood flow (top half of image) and continuous venous flow (lower half of image) in the severely damaged left femoral vein (lcfv) of the patient in figure 9 (case study D). Compare this reduced, continuous flow with the normal venous flow pattern in figure 2.
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F10
The FV is much smaller than the artery (Figure 9) with reduced blood flow and a 'continuous' flow pattern (Figure 10) indicating partial outflow obstruction.
PMC3305527_05
No blood flow, very severe damage (grade 4). Dual-frame image from a 37-year old groin injector (see case study E). The left femoral vein (lcfv) is small and occluded by an echogenic material (organised blood clot). Note the absence of post-acoustic shadow behind the vein (arrows). The damage was graded as very-severe (grade 4).
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F11
FV in his groin. Figure 11 shows a small, sclerosed FV containing echogenic material (organised blood clot) with no blood flow.
Alternative venous drainage, very severe damage (grade 4). B-mode image showing a very-severely damaged left femoral vein (lcfv) and new vessels (vv), providing alternative routes for venous drainage.
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F12
New venous 'channels' are often seen in patients with severely damaged FV (Figure 12).