Ultrasonic vascular imaging has been used for more than 20 years to define vascular anatomy, pathologic changes in vessel size, and perivascular abnormalities. In the last decade, development of duplex Doppler technology has permitted the evaluation of both anatomic vascular features and physiologic blood flow parameters in a variety of locations. Doppler "color flow" imaging promises to expand these applications. In many instances, duplex Doppler technology has replaced more invasive angiographic procedures for evaluation of suspected vascular abnormalities. Improved ultrasound duplex technology, combined with the relatively inexpensive, rapid, noninvasive aspects of ultrasonography has made it a valuable screening examination for suspected flow abnormalities. (JAMA. 1991;265:2382-2387 SONOGRAPHIC imaging to define vascular anatomy, pathologic changes in vessel size, intraluminal thrombi and