A Renal Arteriovenous Malformation Case Study: The Importance of Utilizing Color Doppler During Point-of-Care Sonography

Abstract

Sonography has been proven to be a safe and cost-effective imaging modality for a variety of medical conditions. The increased portability of ultrasound equipment has led to the introduction of nonsonographers performing limited studies in a variety of clinical scenarios. Point-of-care sonography (POCS) has many advantages, including, but not limited to, more efficient diagnoses, focused treatment options, and, in some cases, eliminating additional, more expensive imaging studies. POCS should be used by individuals formally trained to understand the instrumentation of the equipment. The specific equipment settings should include power output, concept of ALARA (As Low As Reasonably Achievable), equipment limitations, image optimization, recognition of 2D landmarks within the human body, and analysis of color Doppler signals. The physician conducting POCS in this case has been through the ultrasound accreditation process associated with the American Urological Association and the American Institute of Ultrasound in Medicine. 1 This case study illustrates how POCS was employed by a physician in conjunction with a thorough patient history and physical examination to detect an atypical urology problem.

Ultrasound diagnosis of renal arteriovenous malformation in a young adult: An underrecognized cause of recurrent haematuria

“…9 DSA is the "gold standard" imaging technique for the diagnosis and treatment planning of renal AVMs, however due to its invasive nature a dedicated CT renal angiogram is the preferred minimally-invasive imaging modality of choice for the preoperative management of renal vascular abnormalities. 10,11 The management options related to renal AVMs are prioritized based on patient symptomatology and hemodynamic status. Asymptomatic or minimally symptomatic small renal AVMs in hemodynamically stable patients can be managed conservatively.…”

“…Ultrasound due to its non‐invasive nature and when supplemented by color and power Doppler is cited to be highly effective in providing a confident diagnosis of renal AVMs 9 . DSA is the “gold standard” imaging technique for the diagnosis and treatment planning of renal AVMs, however due to its invasive nature a dedicated CT renal angiogram is the preferred minimally‐invasive imaging modality of choice for the preoperative management of renal vascular abnormalities 10,11 …”