Repeatability of Duplex Ultrasound Venous Reflux Parameters

Abstract

Objective: To determine which method of eliciting venous reflux allows obtaining more repeatable venous reflux parameters measured by duplex ultrasound (DU), and which of these parameters is most repeatable.

Materials and methods: Sixteen limbs with chronic venous insufficiency were measured for venous reflux parameters at superficial femoral vein: SFV and great saphenous vein: GSV, twice under Valsalva maneuver and cuff compression by two different examiners using DU.

The venous reflux parameters were • venous reflux time • peak venous reflux velocity • timed average venous reflux velocity • venous reflux time velocity integral • total reflux volume • timed average reflux volume • venous reflux time index • peak venous reflux velocity index • timed average venous reflux velocity index • venous reflux time velocity integral index (Index-type parameters which are the rate between reflux and outflow).

The intra- and inter- observer repeatability of these venous reflux parameters were judged from the testretest reliability (Correlation Coefficient: CC).

Results: 1) The Valsalva maneuver elicits 13 SFV and 7 GSV refluxes by two examiners, the cuff compression method, 7 SFV and 13 GSV refluxes. 2) The inter-observer CC of all parameters between first and second examination was worse than inter-observer CC. 3) Seven of 10 intra-observer and 8 of 10 inter-observer CC of parameters under cuff compression were higher than that under Valsalva maneuver.

4) The CC of peak venous reflux velocity index and venous reflux time velocity integral index under cuff compression were best of all parameters.

Conclusion: The peak venous reflux velocity index and venous reflux time velocity integral index under cuff compression were most repeatable, and should be good quantitative venous reflux parameters.