J Korean Soc Ultrasound Med.  2011 Dec;30(4):251-256.

Color Doppler Ultrasound of Lower Extremity Varicose Veins: A Simple Grading of Sapheno-Femoral Junction Reflux

• Huh S
• Hong SJ
• Kim SK
• Park SW
• Hong SH
• Kim YS

Abstract

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.

Keyword

Varicose veins; Lower extremity; Ultrasonography, Doppler, Color

MeSH Terms

Humans
Leg
Lower Extremity
Ultrasonography, Doppler, Color
Valsalva Maneuver
Varicose Veins