US duplex findings in chronic venous insufficiency of the lower limbs in 500 Mexican patients

Abstract

Introduction:There are few reports of ultrasound (US) duplex findings in patients with chronic venous insufficiency (CVI). The aims of this study were (1) to describe CVI ultrasound findings of the lower limbs in Mexican patients according to sex and age and (2) to propose a grade classification of CVI based on reflux velocity. Materials and Methods: Adult patients with clinically suspected lower limb CVI were studied in this cross-sectional study. The complete protocol was performed using the following US modalities: grayscale, duplex Doppler, color Doppler, power Doppler, and B-flow examination. The parameters examined were diameter, compressibility, permeability, direction, flow, and reflux velocity in the veins. The grade classification was based on the reflux velocity as grade 1, from 1 to ≤ 10 cm/s; grade 2, from 11 cm/s to 20 cm/s; and grade 3, > 20 cm/s. Results: A total of 500 patients were included. Based on the US duplex findings, 312 (62.4%) women and 131 (26.2%) men were diagnosed with CVI. Insufficiency of the perforating venous system and the age group of 40-49 years were most common in both genders, followed by insufficiency of the superficial venous system. The most frequent association was insufficiency of the superficial venous system with insufficiency of the perforating venous system. CVI grade 3 was more common in the superficial venous system, while similar frequencies were found for the three-reflux grade in deep venous insufficiency. Conclusion: This study shows a complete description of US duplex findings of lower limb CVI from the radiologist's perspective; for the first time, a grade classification based on reflux velocity is proposed.