Carotid ultrasound imaging looks for arterial plaques
When a patient goes in for his or her carotid ultrasound study, the technician’s primary objective is to acquire four standardized measurements from the right and left sides of the neck — eight images in all.
The first is of the distal common carotid artery, and the three others are centered on the site of maximum near or far wall thickening (lesion) in the proximal internal carotid artery or the carotid bulb. The images at the site of maximum thickening are obtained at three different angles. Pulse Wave Doppler measurements are taken at the site of maximum flow acceleration in the distal common carotid artery, bulb, or internal carotid artery. (See photos, p. 43.)
The imaging priorities are first and foremost arterial plaques. If a focal lesion is present, the visualization of the lesion is optimized and centered in the field of view. The second priority is the far wall interfaces and, finally, the near wall interfaces.
The technician draws six lines on each image. (See illustration, p. 42.) Measurements are made from those. It is a relatively simple task for a trained ultrasound reader to draw the lines on a high-quality image of a healthy artery. It is more difficult to analyze diseased arteries.
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