Talk:WikiJournal Preprints/Ultrasonography of chronic venous insufficiency of the legs

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Article information

Author: Lurdes Cerol[i]

, 2020 Missing or empty |title= (help)Wikidata

Plagiarism check[edit source]

Artículo bueno.svg Pass. Report from WMF copyvios tool: Although significant overlap was observed with an external site, that site explicitly states that they incorporate material from the wikipedia article that this submission is based on. T.Shafee(Evo﹠Evo)talk 02:00, 15 August 2019 (UTC)

First Peer review[edit source]

Review by Alberto Caggiati , Sapienza University of Rome, Italy | Vascular Surgeon & Phlebologist
This review was submitted on , and refers to this previous version of the article

I cannot approve that article. This because the anatomy of the venous bed is not correctly described. See page 1 and 5

In fact, the veins of the lower limbs are designated as Deep Veins: N1 or, better, R1; saphenous veins, N2 (or R2); saphenous tributaries and collaterals N3 (or R3). N2 does not designate perforating veins. Moreover, only the saphenous veins are “interfascial”. The other superficial veins are “epifascial”. The “saphenous compartment” contains only the saphenous veins, not the oher superficial veins.

Moreover, the “Mickey Mouse sign” (page 2 and 5) is related to the CFA, CFV and GSV (not to CFA, GSV and AASV, as reported in the article.

My opinion is that the article needs to be completely re-written on the basis of worldwide accepted anatomical concepts.

Finally, if the goal of the article is divulgative, that article must be re-written. It is much oriented only toward a technique for varicose veins treatment.


For the venous anatomy of the lower limbs:

  • Nomenclature of the veins of the lower limb: extensions, refinements, and clinical application.Caggiati A, Bergan JJ, Gloviczki P, Eklof B, Allegra C, Partsch H; International Interdisciplinary Consensus Committee on Venous Anatomical Terminology. J Vasc Surg. 2005 Apr;41(4):719-24.
  • Nomenclature of the veins of the lower limbs: an international interdisciplinary consensus statement. Caggiati A, Bergan JJ, Gloviczki P, Jantet G, Wendell-Smith CP, Partsch H; International Interdisciplinary Consensus Committee on Venous Anatomical Terminology. J Vasc Surg. 2002 Aug;36(2):416-22.
  • Fascial relations and structure of the tributaries of the saphenous veins. Caggiati A. Surg Radiol Anat. 2000;22(3-4):191-6

For the Mickey mouse sign:

  • Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs--UIPconsensus document. Part II. Anatomy. Cavezzi A, Labropoulos N, Partsch H, Ricci S, Caggiati A, Myers K, Nicolaides A, Smith PC. Eur J Vasc Endovasc Surg. 2006 Mar;31(3):288-99. Epub 2005 Oct 14.

For the classification N1-N2-N3 (R1-R2-R3):

  • Franceschi C. CHIVA : Hemodynamic diagnosis and treatment of the Venous Insufficiency DOI: 10.13140/RG.2.1.2530.3527

Second peer review[edit source]

Review by Henry Knipe , Lake Imaging | Royal Australian and New Zealand College of Radiologists
This review was submitted on , and refers to this previous version of the article

General comments
  • Introduce abbreviations once with the first use, e.g. “superficial venous system (SVS)” then use the acronym “SVS” throughout the remainder of the article.
  • Explanation of basic science terms such as “Haemodynamics” are not required and unnecessarily lengthen the article - those core topics are considered core knowledge and can be linked through to relevant Wikipedia articles.
  • Replace “anterograde” (forward in time) with “antegrade” (forward moving) throughout the manuscript.
  • Accessory saphenous vein usually refers to anterior accessory saphenous vein (as you’ve linked to the Wikipedia article in the Particular details/Great saphenous vein section) and you need to specify either anterior or posterior accessory saphenous vein to avoid confusion.
  • Recommend removing any patient data from clinical images - this includes time/date stamps and institution information.
  • This article could use review for word choice, clarity, grammar and punctuation.
  • Remove “risk-free” (replace with low-risk if you like). Whilst the biologic effects of ultrasound is considered so low it is considered “safe”, one can imagine an incidental finding being acted upon with deleterious effects, and thus this can be considered a “risk” of undergoing the examination.
  • Ultrasonography is very good at assessing the deep veins as well as the superficial veins.
  • Replace the first use of “It” with the specific term you are referring to.
  • Remove “is harmless” as this is not necessarily true (e.g patient discomfort pain or discomfort during examination).
  • Consider rewording of “any age” - guidelines recommend limiting the use power Doppler on a fetus (although not everyone would consider this an “anybody”)
  • Provide working link for reference 5
  • Suggest rephrasing “ mainly at the superficial level” to “of the superficial venous system” so it is clear the subject are the veins and not the “invaluable information”
  • Confusion between “colour” and “Doppler imaging” - the preferred terms are “colour Doppler” and “spectral Doppler” as both use the Doppler effect; colour Doppler +/- spectral Doppler are superimposed on grey scale (B-mode) ultrasound
  • Ultrasound examinations is not limited to just radiologists - sonologists, vascular surgeons and vascular physicians may perform these studies - a more generic term would be better.
  • First paragraph is redundant (see general comments) and should be shortened to one sentence.
  • Expertise of the examiner is mentioned again. Probably only needs to be mentioned once in Equipment or Mechanism.
  • I generally feel this whole section is redundant.
  • Second paragraph could be made into its own section “Pathology” or “Pathophysiology”
  • Recommend focussing on what an ultrasound examination of chronic venous insufficiency is rather than comparing what other ultrasound examinations are not.
  • Deep veins are also assessed in ultrasound of lower limb venous insufficiency.
  • “Manual squeezing and releasing” is also known as “augmentation”.
  • Delete “(Proprioceptive refers to a response to a perceived stimulus especially with regard to movement and position of the body)”, especially as link to Wikipedia article is provided - see General comments about redundant information.
Technical difficulties
  • Either delete, caveat as personal opinion, or cite reference for assertion in first sentence.
  • I am unsure what “(by hyper-debit)” means.
  • “Also, by definition of insufficiency (insufficient blood flow) blood may be seen to flow freely in both directions, anterograde and retrograde between two valves” does not make sense and needs rewriting.
Particular details
  • Accessory saphenous vein
    • “The anterior ASV is more anterior than the ASV and is outside the femoral vessels plan.” does not make sense, did you mean “...more anterior the posterior ASV...”?
  • Perforator veins
    • Introduce “CHIVA”
  • Odd to have at the end of the manuscript.
  • General overview of the history of ultrasound is redundant in this type of technical article.

Editorial recommendation[edit source]

Comments by Thomas Shafee
These comments were submitted on , and refer to this previous version of the article

Given the reviewers' comments, we must decline to publish this article but may consider after a re-write and resubmission, with no prior commitment. If so, the work would be sent to the same reviewers as well as possibly an additional reviewer for checking. We hope that you find the comments useful should you decide to revise the article.