What is the role of ultrasonography in the workup of atherosclerotic disease of the carotid artery?

Updated: Oct 04, 2018
  • Author: Jake F Hemingway, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Carotid duplex ultrasonography (US), with or without color, is the screening test of choice to evaluate for carotid stenosis. Many surgeons operate after seeing the results of a carotid duplex study alone if the laboratory has credentials and is validated. (See the images below.)

Normal carotid arteries on color flow duplex ultra Normal carotid arteries on color flow duplex ultrasonography.
Color flow duplex ultrasonogram reveals 80-99% lef Color flow duplex ultrasonogram reveals 80-99% left carotid stenosis and normal right carotid.

In a study by van Engelen et al that used three-dimensional US  to evaluate 298 patients with carotid atherosclerosis, changes in carotid plaque texture and volume were found to be strong predictors of vascular events (eg, myocardial infarction [MI], transient ischemic attack [TIA], and stroke). [13]


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