Resumen:
Introducción: Hay pocos informes sobre los hallazgos de duplex por ultrasonido (US) en pacientes con insuficiencia venosa crónica (IVC). Los objetivos de este estudio fueron (1) describir los hallazgos de ultrasonido de IVC en las extremidades inferiores en pacientes mexicanos según el sexo y la edad y (2) proponer una clasificación por grados de IVC basada en la velocidad de reflujo. Materiales y Métodos: Se estudiaron pacientes adultos con sospecha clínica de IVC en las extremidades inferiores en este estudio transversal. Se realizó el protocolo completo utilizando las siguientes modalidades de US: escala de grises, duplex Doppler, Doppler color, Doppler de potencia y examen B-flow. Los parámetros examinados fueron diámetro, compresibilidad, permeabilidad, dirección, flujo y velocidad de reflujo en las venas. La clasificación por grados se basó en la velocidad de reflujo como grado 1, de 1 a ≤ 10 cm/s; grado 2, de 11 cm/s a 20 cm/s; y grado 3, > 20 cm/s. Resultados: Se incluyeron un total de 500 pacientes. Basado en los hallazgos de duplex por US, 312 (62.4%) mujeres y 131 (26.2%) hombres fueron diagnosticados con IVC. La insuficiencia del sistema venoso perforante y el grupo de edad de 40 a 49 años fueron los más comunes en ambos géneros, seguidos por la insuficiencia del sistema venoso superficial. La asociación más frecuente fue la insuficiencia del sistema venoso superficial con la insuficiencia del sistema venoso perforante. El grado 3 de IVC fue más común en el sistema venoso superficial, mientras que se encontraron frecuencias similares para los tres grados de reflujo en la insuficiencia venosa profunda. Conclusión: Este estudio muestra una descripción completa de los hallazgos de duplex por US de la IVC en las extremidades inferiores desde la perspectiva del radiólogo; por primera vez, se propone una clasificación por grados basada en la velocidad de reflujo.

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.

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.