Journal of Korean Society of Ultrasound in Medicine 2011;30(4): 251-256.
Color Doppler Ultrasound of Lower Extremity Varicose Veins: A Simple Grading of Sapheno-Femoral Junction Reflux.
Sik Huh, Suk Joo Hong, Shin Kee Kim, Sang Woo Park, Sun Hwa Hong, Yeon Soo Kim
1Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Korea.
2Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Korea.
3Department of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Korea.
  Published online: December 1, 2011.
PURPOSE: To establish a simple grading method for the severity of an incompetent sapheno-femoral junction (SFJ) using color Doppler ultrasound in patients with lower extremity varicose veins. MATERIALS AND METHODS: 346 legs of 241 consecutive patients with varicose veins were examined (M:F = 96:145, 11-74 years, mean 50 years). The severity of SFJ and sapheno-popliteal (SPJ) incompetence was graded from I to IV according to the patient's position (standing versus supine or prone) and whether the Valsalva's maneuver had been induced. The extent of varicose veins was graded as I to III by the US findings in the SFJ incompetence group. The grading of SFJ incompetence was compared to the extent of varicose vein. RESULTS: SFJ, SPJ, both SFJ and SPJ, and perforator incompetence was observed in 198 (57.2%), 81 (23.4%), 21 (6.1%) and 54 (15.6%), respectively. Among the SFJ incompetence group, severity grade I - IV were observed in 14 (7.1%), 75 (37.9%), 73 (36.9%), and 36 (18.2%), respectively, and the extent grade I - III were noted in 47 (23.7%), 95 (48.0%), and 56 (28.3%), respectively. The SFJ incompetence grade and varicose extent grade showed a positive correlation (p < 0.0001). CONCLUSION: Simple sonographic grading of the severity of SFJ incompetence is possible. The extent of varicose veins in the SFJ incompetence group can be determined using this new grading system.
Keywords: Varicose veins; Lower extremity; Ultrasonography, Doppler, Color
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