1. Class of Recommendation and Level of Evidence 5
2. Summary of the Main Recommendations 5
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Images
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– Schematic representation of intima-media thickness and carotid plaque measurements. IMT measurement (A). Three different measurements of the carotid plaque (CP): B) extending ≥ 0.5 mm into the vessel lumen; C) > 50% of the surrounding IMT; D) IMT > 1.5 mm.
– Residual lumen measurements by (A) B-flow imaging, (B) B-flow angiography, and (C) color Doppler. B-flow techniques have less color overlap over the plaque and are the imaging methods of choice for residual lumen measurement.
– Internal carotid artery stenosis of 70% to 79%. A) Common carotid artery flow; B) Internal carotid artery stenosis on color Doppler; C) Internal carotid artery flow in the stenosis; D) Poststenotic turbulent flow in the internal carotid artery.
– Internal carotid artery stenosis of > 90%. A) Common carotid artery flow; B) Internal carotid artery flow.
– Total occlusion of the internal carotid artery (ICA). A) Undetectable flow in the ICA on color Doppler; B) Absence of contrast enhancement in the ICA lumen.
– Common carotid artery stenosis. A) B-mode imaging; B) Color Doppler; C) Power Doppler; D) High PSV in the CCA stenosis; E) Pre stenotic PSV; F) Transverse plane showing significant narrowing of the residual lumen. PSV: peak systolic velocity.
– Echo enhancer in calcified plaques demonstrating > 70% stenosis (near occlusion) at the beginning of the left internal carotid artery (green circle). A. When using microbubbles, the contrast medium passes through the plaque, and contrast is observed beyond the stenosis (green circle) between 27 and 34 seconds after intravenous injection of SonoVue®. In B-mode imaging, check difficulty at the site of stenosis according to the acoustic shadow (green circle).
– Schematic representation of the circle of Willis (9A) and contrast-enhanced ultrasound image in the right temporal window (9B).
– Transcranial Doppler in the transorbital window (10A); schematic representation of insonated arteries (carotid siphon and ophthalmic – 10B).
– Transcranial Doppler in the transtemporal window (11A); schematic representations of the anterior (11B), middle (11C), and posterior (11D) cerebral arteries.
– Transcranial Doppler in the foraminal window (12A); schematic representation of the basilar and vertebral arteries (12B). RV: right vertebral; LV: left vertebral.
– Adjustable headset for transducer fixation and continuous flow monitoring in middle cerebral arteries. TCD: transcranial Doppler.
– High-intensity transient signals indicating emboli (gas or solid).
– TCerebral vasomotor reserve capacity assessment through the CO2 inhalation test; significant reductions in velocities and the resistance index (15B) were observed after CO2 inhalation (15A).
– Anatomy of the intracranial segments of the vertebral and basilar arteries and their branches (16A); foraminal window: color flow mapping in vertebral lumens (V4) and PICAs (16B); color mapping of transition from vertebral V3 (extra) to V4 (intracranial – 16C); spectral curve on pulsed Doppler moving away from the transducer (V4) (16D); color flow mapping of the left PICA (flow towards the transducer – 16E); and spectral curves on pulsed Doppler of the left PICA (16F). PICA: posterior inferior cerebellar artery.
Comments are moderated by the editorial team before publication. Discussions should be evidence-based and use scientific language. Conflicts of interest should be declared.
Comments are moderated by the editorial team before publication. Discussions should be evidence-based and use scientific language. Conflicts of interest should be declared.