Axillary Artery B-Mode, Color & Spectral Doppler Ultrasound Normal Vs Abnormal Image Appearances USG

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Axillary Artery B-Mode, Color & Spectral Doppler Ultrasound Normal Vs Abnormal Image Appearances USG

*Cases
0:00 - Stenosis
4:24 - Aneurysm
5:04 - Pseudoaneurysm
6:01 - Vasculitis
6:53 - Dissection

Normal Axillary Artery:
Diameter: Typically 6–8 mm depending on patient size
PSV: Typically 50–100 cm/s. Can vary
End-Diastolic Velocity (EDV): Low or absent in high-resistance flow.
Acceleration Time: Rapid upstroke ( less than 140 ms)

Stenosis:
Color Doppler: Aliasing at the stenotic site (mosaic pattern)
Spectral broadening: indicates loss of laminar flow
Chaotic or disturbed waveform distal to stenosis
Mild stenosis: 1.5× normal PSV
Moderate stenosis: 2× normal PSV
Severe stenosis: More than 3× normal PSV (often greater than 300 cm/s)

Aneurysm:
May occur due to Thoracic Outlet Syndrome, but rare.
Focal dilation of the artery ( more than 1.5× normal diameter).
Color Doppler shows swirling flow ("yin-yang" pattern).
May have thrombus layering along the walls.

Pseudoaneurysm:
Blood collects outside the arterial wall but is still contained by the surrounding tissues. It forms when there is a breach in the arterial wall, typically from trauma, surgery, or an arterial puncture, allowing blood to escape the vessel but remain confined near it.
Neck connecting the artery to the hematoma.
To-and-fro flow on spectral Doppler at the neck.
Color Doppler shows yin-yang sign in the sac.

Vasculitis:
Concentric wall thickening with or without stenosis.
Reduced or absent flow in severe cases.
Long segments of narrowed artery.

Dissection:
Tear in the intimal layer of the artery, allowing blood to enter between the layers of the wall and create a false lumen.
Intimal flap inside the lumen separating true and false lumens.
Sometimes appears as a mobile linear echogenic membrane.
Arterial wall may look thickened or irregular.