The Vascular Ultrasound application covers transcranial, carotid, upper extremity artery and vein, aorto-iliac, mesenteric, renal, abdominal vein, lower extremity artery and vein reports. Reports can be done singularly, or combined, e.g. an aorto-iliac report with a distal runoff.
- Prerequisites before reading this article: How do I use EncaptureMD? (basic overview with VIDEO)
- Your version of the vascular app may have some of these tabs hidden. They are still there, but deactivated because your facility does not perform that test.
- Screen layout laterality is presented as if you are looking at the patient -e.g. left side of patient on right side of screen.
- The History, Exam and Recommendations tabs are self-explanatory and not covered here. They are optional to use.
- Each tab has a Study Type combo box - make sure that is set. Some measurements exists between studies. The aorto-iliac report and the LE arterial report both contain information about the iliac arteries. The subclavian artery is in both the carotid and UE arterial reports. Choosing the Study Type ensures these measurements will be associated with the correct/ordered study.
Table of Contents/Navigator
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TCD (no video)
Transcranial doppler examinations can be viewed either referenced by artery/anatomy or by acoustic window. In either case, the output report is the same. Make sure to go to the Conclusion tab to finish the study.
View by artery
The areas in the red boxes will be populated from the US machine. Fill out anything abnormal for both right (1) and left (2) sides, then click the All else normal buttons (3,4) to finish the entry
View by window
This screen has the same data as View by Artery, just reformatted. Function is otherwise the same.
Conclusion/Drawing
Use the phrase generator on the left (1) or free text a summary in the text area (2). There is also a template tool (3) that can be set to add a set of conclusion templates that can be used.
Choose a drawing (4) then sketch if desired.
Carotid (with VIDEO)
The measurements in the red box will import from the US machine.
- Use the phrase generators for right and left to create descriptions of abnormal plaques. Make sure to click the Add button to push the results into the report.
- Click the All Normal buttons -OR- enter abnormal findings (right and left) then click the All else normal buttons to complete the study.
Note: either the Normal checkbox should be checked OR there should be data in the text areas.
IMT/Drawing
The IMT/Drawing tab allows the user to enter incidental information about thyroid abnormalities as well as use the Drawing tool.
UE Arterial (no video)
Segmentals/PVRs
- Arm segmental pressures can be entered manually in this section.
- Pulse volume recording information can be entered here.
- Allen test information for each radial and ulnar artery is entered here. Note the All else normal button.
- Doppler velocities and Waveforms is best used when the acquisition is by non-imaging transducer and not a full Duplex scan.
- This section is for the conclusion information for this section.
UE arterial duplex
- The right and left arm plaque phrase generators allow the user to build plaque descriptions.
- Numeric values from the US machine will populate here. The waveforms combo box must be manually entered.
- The diagnosis phrase generator and combo box construct the conclusion.
Note: brachiocephalic is unpaired.
Thoracic outlet obstruction maneuver testing
- Choose the artery being monitored
- Fill out the abnormal maneuvers for right and/or left
- Click the All else nl buttons
PPG
Fill out the abnormal findings and then click All else nl. If there are no abnormal values, just click All else nl.
Cold sensitivity
- Choose method used
- Choose finger tested, control and enter reference finger pressure.
- Click the +Add button to add rows to each table.
- Add the minimum test finger pressure. The index will calculate
- Use the Results phrase generator to create the conclusion phrase.
UE Venous (no video)
- If the right UE veins are normal, click the Right Normal button.
- If the right UE veins are not normal, add in the abnormality in the row or rows that correspond to the abnormality, using each column to describe the anomly, its description, echogenicity and occlusivity.
- Then click the Right All Else Normal button.
- See example of a row filled out. Text will generate to the report.
- The General Right and Left go to the conclusion/summary.
The same instructions apply to the left side. Mapping and additional findings can also be entered each side.
Dialysis (no video)
- The upper part of the tab is used for dialysis vein mapping. Measurements should flow in from the US machine. Mark any mapped vessels too small as indicated.
- The bottom of the tab is used to assess existing fistulae and grafts.
Aortoiliac (no video)
- The abdominal aortic dimensions and velocities should import from the US machine. The General combo box should be filled out for all studies.
- If the patient has an abdominal aortic aneurysm, use the phrase generator to describe.
- If a dissection is present, again use the phrase generator to describe.
- Calcification-use the phrase generator to describe.
- Atherosclerosis-use the phrase generator to describe.
- The common external and internal iliac arteries can be reported here. Measurements (dimensions and velocities) should populate to the right. The combo boxes (%stenosis-waveform) must be manually entered.
- The left mimics the right.
- If the patient has a graft, it can be described here.
- If it is an endograft leak, use this area
- For drawings, use the drawing tool.
Mesenteric
The mesenteric tab has its own specific history and exam which can be used in addition to the main app history and exam.
Vessels allows for reporting on plaques using the Plaque imaging phrase generator and comments on each of the unpaired mesenteric vessels.
Measurements for pre and post prandial will transfer here.
Note: many US machines cannot send post-prandial measurements. In those cases, they have to be manually entered.
Renal
- For both left and right, the General combo box populates the conclusion.
- Measurements from the US machine will populate here
- The Results combo box also populates the conclusion.
- Uncommon other findings can be entered here.
- Masses can be commented upon using the Masses phrase generator.
Abdominal venous
- The Normal Veins button will populate the fields as indicated in (4)
- If thrombus is present, mark the location Yes and then add severity and degree of occlusion
- Use the Normal-no thrombus button to finish the remaining rows.
LE Arterial (with VIDEO)
ABI/Segmentals/PVR
- The first section is used for segmental pressures, the most common of which is the ankle-brachial index (ABI). Most modalities that record pressures do not output results to a reporting system, so these values most often are entered manually. The calculations are automatic and the ABI and toe pressure results are also set automatically. Use the Stress ABI tab instead of this area if you are reporting a stress ABI study.
- Pulse volume recording (PVR) is similar to segmentals in that the modality is not likely to export its data. Manually choose the result here. If you have a Parks FlowLab and the EncaptureMD-FlowLab integration, use the FloLab tab instead of here.
- This section is used to report on vessel velocities recorded usually acquired with a non-imaging transducer or equipment. Again, the modality may not output this data (unlike the Duplex study) electronically so has to be manually entered. Use the Duplex tab for full duplex studies. The measurements will transfer here.
- The Conclusion of the study can be reported here. Choose the abnormal values and then click All else normal.
Stress ABI
- The stress ABI study can be reported here. Choose the protocol and enter the appropriate information
- If claudication symptoms are noted, they can be reported here.
- The Treadmill Time button will set the time column as shown below. The remainder of that table is manually entered. The graph generates from the table.
Duplex
- Use the phrase generators at the top to describe abnormal plaques
- The velocities/diagrams will be populated from the US machine in this section. The user must fill out the waveform if required.
- The conclusion information is provided here. Note: the aorto-iliac is unpaired. The All else normal button fills out anything not abnormal with a zero value.
- Additional findings can be entered here.
Grafts/Diagrams
- Graft analysis can be commented upon using the phrase generator.
- Choose an image (leg arteries is the only choice) and then sketch any anomalies.
Pseudoaneurysm
Enter relevant data into the fields to construct the report. The measurements will likely not cross from the US machine so must be manually entered.
LE Venous (with VIDEO)
Duplex
- If the duplex exam is normal for that side, click the <side> Normal button.
- If the exam is abnormal, define the abnormality by setting the location, description, echogenicity and occlusive combo boxes then
- Click the <side> All Else Nl button
- Note: the General Left in this example is not set by the All Else Normal button. It has to be set manually.
- The additional vessels are not set by the buttons. They must be entered individually below the knee.
- At the bottom, enter any additional findings
Spectral Analysis
- Similar to Duplex - if side normal, click the Normal button.
- If vessel abnormal, fill out the row or rows of the corresponding vessel, then click All Else Nl
Reflux
Again, similar to Duplex and Spectral Analysis.
- Set the patient position. There is only one protocol, but it has to be set as well
- If the side is normal, click the Normal button
- If the vessel has reflux, fill out its row
- Then clikc the All Else Normal button
- Additional anomalies can be entered at the bottom.
Drawings
- Choose a drawing to use (there are multiple options here)
- Draw the anomaly.
- Suggestions - thrombus as red and varicosities as black or blue squiggle.
