Figure 9b. IVC stenosis. (a, b) Right paramedian sagittal gray-scale US (a) and color Doppler (b) images show focal narrowing of the IVC lumen with associated flow turbulence secondary to a stricture at the distal IVC anastomosis (arrows). (c) Spectral Doppler image shows a twofold increase in velocity between the prestenotic (right arrow) and poststenotic (left arrow) IVC segments with turbulent flow in the poststenotic segment. A satisfactory waveform could not be obtained at the stenosis due to artifact from the surgical sutures. Although the stenosis was significant at gray-scale and Doppler US, the patient was asymptomatic and the referring clinicians decided to monitor the stenosis with US follow-up.