Quiz - Ultrasound Evaluation of Renal Artery Stenosis

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1. Which waveform below demonstrates a tardus parvus appearance?


2. When performing Doppler analysis of the segmental renal arteries, the Doppler angle should be:

Less than 30 degrees

60 degrees

45-60 degrees

90 degrees


3. The most optimal patient positioning for imaging the intrarenal vasculature of the right kidney is:

Supine

Left lateral decubitus

Right lateral decubitus

Prone


4. Which of the following is considered to be a normal RAR?

2

3.5

4

5.5


5. Which of the following most accurately describes the normal course of the left renal vein?

Retroaortic

Between the SMA and splenic vein

Underneath the IVC

Anterior to the aorta and posterior to the SMA


6. Which intrarenal arteries normally course above the renal pyramids toward the periphery of the kidney?

Arcuate

Segmental

Interlobular

Interlobar


7. A landmark for locating the left renal artery is:

Left renal vein

Splenic vein

Gastroduodenal artery

Inferior mesenteric artery


8. A false negative indirect renal Doppler study is most likely to occur due to which of the following:

Patient was not NPO

RI is above 0.70

RI is below 0.70

Aortic aneurysm


9. The angiographic appearance termed "string of pearls" is seen with:

High grade renal artery stenosis

Renal artery dissection

Renal artery aneurysm

Renal artery fibromuscular dysplasia


10. What parameter is incorrectly measured in this Doppler waveform of a segmental renal artery?

End diastole

AT

RI

All of the above


11. What parameter is incorrectly measured in this Doppler waveform of a main renal artery?



Peak systole

End diastole

Both peak systole and end diastole are measured incorrectly

Both peak systole and end diastole are measured correctly


12. Which of the following is likely to result in a false negative study for renal artery stenosis using the direct method?

Stenosis in an accessory renal artery

RI above 0.70

RI below 0.70

Aortic aneurysm


13. Which of the following is not recommended as a way to improve spectral quality with the indirect method for evaluating renal artery stenosis?

Adjust sweep speed to show a display of only 2-3 seconds

Adjust PRF so that the spectral waveform fills the display window

Use small angles of incidence for Doppler interrogation

Use a Doppler frequency below 3 MHz


14. An accurate description of the RAR is:

Maximum renal artery velocity divided by aortic velocity obtained at the level of the aortic bifurcation

Segmental renal artery velocity divided by aortic velocity obtained at the level of the aortic bifurcation

Maximum renal artery velocity divided by aortic velocity obtained at the level of the renal arteries

Minimum renal artery velocity divided by aortic velocity obtained at the level of the aortic bifurcation


15. The normal renal parenchyma echogenicity is:

hyperechoic to the liver

hypoechoic to the liver

equal to the liver

Both B and C are correct