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2014 ; 14
(57
): 179-91
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Standards of the Polish Ultrasound Society - update Examination of extracranial
carotid and vertebral arteries
#MMPMID26673158
Elwertowski M
; Ma?ek G
J Ultrason
2014[Jun]; 14
(57
): 179-91
PMID26673158
show ga
The role of a standard is to describe examination techniques, recommended norms
as well as principles necessary to obtain results and draw appropriate
conclusions, rather than a description of pathologies. The paper presents a
technique for carotid artery examination as well as currently recommended
standards. According to San Francisco Consensus from 2003, a significant stenosis
of 70% may be detected when systolic velocity in the internal carotid artery
stenosis is >230 cm/s, and the diastolic velocity is >100 cm/s. The common
carotid artery velocity is also taken into account. Hemodynamic evaluation is
therefore the primary method for the assessment of the degree of internal carotid
artery stenosis. It is important that the examination is performed at an
insonation angle of 60° as measurements at higher angles result in an exponential
increase in measurement error. Also, an extended version of standards involving
measurements performed behind stenosis, which are used in some clinics, is
included in the paper. The paper further presents guidelines for the description
of the identified pathologies, which ensure that the findings prove unambiguous
for clinicians, especially when stenosis eligible for surgical intervention is
detected. Morphological measurement of stenosis (according to NASCET criteria) is
only of supplementary character (confirming morphological grounds for the
increase of velocity) and has no critical importance, especially due to high
measurement divergence. Description of atherosclerotic plaques, especially
hypoechoic ones, which are considered potentially unstable and may lead to a
raised risk of stroke, is a very important element of examination. The paper is
based on Standards of the Polish Ultrasound Society and updated based on the
latest literature reports.