Although ultrasound is an extraordinary tool, its effectiveness depends largely on the knowledge and experience of the examiner. Most ultrasounds are performed by ultrasound technologists, who are radiology technologists with additional training. They are excellent in what they do, but leg venous ultrasound exams should be performed by a registered vascular technologists (RVT). RVT is a certification offered by the American Registry of Diagnostic Medical Sonographers (ARDMS).
Although RVTs are well-trained professionals, they primarily perform ultrasound exams to assess deep vein thrombosis (DVT) and blood-clot problems. During these exams, patients are usually in a supine rather than standing position, and that’s perfectly appropriate.
However, to detect venous reflux problems, the patient should be in a standing position. This allows the examiner to perform leg compression maneuvers, especially of the calf and thigh muscles, and use the color-flow duplex feature of the ultrasound to determine which valves are leaking.
Although these exams usually detect any active blood-clot complications, they provide little or no useful information for addressing such CVI issues as long-term pain, swelling or varicose veins.
That’s why physicians who specialize in the treatment of vein disease should take the time and effort to obtain RVT qualification. To deliver the best quality care, they should perform their own ultrasound examinations and use ultrasound to guide them in treatment.