Annex M Vascular Ultrasound Reports (Informative)

M.1 Vascular Report Structure

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Figure M.2-1 Vascular Numeric Measurement Example

The vascular procedure report partitions numeric measurements into section headings by anatomic region and by laterality. A laterality concept modifier of the section heading concept name specifies whether laterality is left or right. Therefore, laterally paired anatomy sections may appear two times, once for each laterality. Findings of unpaired anatomy, are separately contained in a separate “unilateral” section container. Therefore, in vascular ultrasound, laterality is always expressed at the section heading level with one of three states: left, right, or unilateral (unpaired). There is no provision for anatomy of unknown laterality other than as a TEXT content item in the summary.

Note that expressing laterality at the heading level differs from OB-GYN Pelvic and fetal vasculature which expresses laterality as concept modifiers of the anatomic containers.

Section Heading Concept Name Section Heading Laterality
Cerebral Vessels Left, Right or Unilateral
Artery of Neck Left, Right
Artery of Lower Extremity Left, Right
Vein of Lower Extremity Left, Right
Artery of Upper Extremity Left, Right
Vein of Upper Extremity Left, Right
Vascular Structure of Kidney Left, Right
Artery of Abdomen Left, Right or Unilateral
Vein of Abdomen Left, Right or Unilateral

The common vascular pattern is a battery of measurements and calculations repeatedly applied to various anatomic locations. The anatomic location is the acquisition context of the measurement group. For example, a measurement group may have a measurement source of Common Iliac Artery with several measurement instances and measurement types such as mean velocity, peak systolic velocity, acceleration time, etc.

There are distinct anatomic concepts to modify the base anatomy concept. The modification expression is a content item with a modifier concept name and value selected from a Context Group as the table shows below.

Anatomic Modifier Concept Name Context Group Usage
(G-C171, SRT, “Laterality”) CID 244 Laterality Distinguishes laterality
(G-A1F8, SRT,”Topographical Modifier“) CID 12116 Vessel Segment Modifiers Distinguishes the location along a segment: prox, mid, distal, …
(125101, DCM, “Vessel Branch”) CID 12117 Vessel Branch Modifiers Distinguishes between one of muliple branches: inferior, middle

M.2 Vascular Examples

The following are simple, non-comprehensive illustrations of significant report sections.

M.2.1 Example 1: Renal Vessels

Nest Code Meaning of Concept Name Code Meaning or Example Value TID
1 Vascular Ultrasound Procedure Report 5100
1.1 Language of Content Item and Descendants English 1204
1.2 Subject Name John Doe 1007
1.3 Subject ID 123-45-9876 1007
1.4 Procedure Study Instance UID 1.2.842.111724.7678.12.33 1005
1.5 Procedure Study Component UID 1.2.842.111724.7678.55.33 1005
1.6 Procedure Accession Number 20011007-21 1005
1.7 Patient Characteristics 5101
1.7.n ,,, 5101
1.8 Summary 5102
1.8.n 5102
1.9 Findings 5103
1.9.1 Finding Site Vascular Structure Of Kidney 5103
1.9.2 Laterality Right 5103
1.9.3 Renal Artery 5104
1.9.3.1 Topographical Modifier Origin 5104
1.9.3.2 Peak Systolic Velocity 420 cm/s 300
1.9.3.3 End Diastolic Velocity 120 cm/s 300
1.9.3.4 Resistive Index 3.7 300
1.9.3.5 Pulsatility Index 0.7 300
1.9.3.6 Systolic to Diastolic Velocity Ratio 3.5 300
1.9.4 Renal Artery 5104
1.9.4.1 Topographical Modifier Proximal 5104
1.9.4.n . . . other measurements 300
1.9.5 Renal Artery 5104
1.9.5.1 Topographical Modifier Middle 5104
1.9.5.n . . . other measurements 300
1.9.6 Renal Artery 5104
1.9.6.1 Topographical Modifier Distal 5104
1.9.6.n . . . other measurements 300
1.9.7 Renal Vein 5104
1.9.7.1 Topographical Modifier Middle 5104
1.9.7.2 Peak Systolic Velocity 120 cm/s 300
1.9.7.n . . . other measurements 300
1.9.8 Renal Artery/Aorta Velocity Ratio 2.9 5103
1.9.n other renal vessels 5104
1.10 Findings 5103
1.10.1 Finding Site Vascular Structure of Kidney 5103
1.10.2 Laterality Left 5103
5104

M.2.2 Example 2: Carotids Extracranial

Nest Code Meaning of Concept Name Code Meaning or Example Value TID
1 Vascular Ultrasound Procedure Report 5100
1.n …. 5100
1.10 Findings 5103
1.10.1 Findings Site Artery of neck 5103
1.10.2 Laterality Right 5103
1.10.3 Common Carotid Artery 5104
1.10.3.1 Topographical Modifier Proximal 5104
1.10.3.2 Peak Systolic Velocity 80 cm/s 300
1.10.3.3 Peak Systolic Velocity 88 cm/s 300
1.10.3.4 Peak Systolic Velocity 84 cm/s 300
1.10.3.4.1 Derivation Mean 300
1.10.4 Common Carotid Artery 5104
1.10.4.1 Topographical Modifier Middle 5104
1.10.4.2 Peak Systolic Velocity 180 cm/s 300
1.10.5 Common Carotid Artery 5104
1.10.5.1 Topographical Modifier Distal 5104
1.10.5.2 Peak Systolic Velocity 180 cm/s 300
1.10.6 Carotid bulb 5104
1.10.6.1 Peak Systolic Velocity 190 cm/s 300
1.10.7 Internal Carotid Artery 5104
1.10.7.1 Topographical Modifier Proximal 5104
1.10.7.2 Peak Systolic Velocity 180 cm/s 300
1.10.8 Internal Carotid Artery 5104
1.10.8.1 Topographical Modifier Distal 5104
1.10.8.2 Peak Systolic Velocity 180 cm/s 300
1.10.9 ICA/CCA velocity ratio 1.5 5103
1.10.n …. 300
1.11 Findings 5103
1.11.1 Finding Site Artery of neck 5103
1.11.2 Laterality Left 5103
….