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E2379. Abnormal Carotid Ultrasound
Authors
  1. Trinh Nguyen; University of Rochester
  2. Jarett Thelen; University of Rochester
Background
Carotid ultrasonography (US) is a primary screening tool for diagnosing extracranial stenotic or occlusive neurovascular disease, typically performed before carotid endarterectomy. Ultrasonography is inexpensive, readily available, and provides an effective means for carotid atherosclerotic disease screening when performed using appropriate technical parameters. Information regarding the plaque morphology, intima-media thickness, and peak systolic velocities allow the radiologist to effectively assess the degree of arterial stenosis or occlusion. Diagnostic dilemma arises when atypical waveform patterns or unexpected pathology are encountered. This exhibit presents a series of abnormal spectral Doppler waveforms and pathology encountered in carotid ultrasonographic imaging with correlative multimodality imaging.

Educational Goals / Teaching Points
After viewing this exhibit, the learner will be able to 1. Recognize abnormal spectral configurations associated with various stenotic lesions or abnormal pathology. 2. Correlate abnormal carotid ultrasound findings with cross-sectional imaging 3. Recognize when further evaluation with cross-sectional imaging is warranted.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A series of abnormal spectral Doppler waveforms and pathology encountered during carotid ultrasonography (US) is presented with correlative computed tomography (CT), angiography, and magnetic resonance (MR) imaging.

Conclusion
Carotid ultrasonography is a primary screening tool for neurovascular disease. Although imaging findings are frequently straightforward, diagnostic dilemmas can arise when atypical waveforms or unexpected pathology are encountered. A critical assessment of the characteristics of the carotid and vertebral Doppler waveforms can help radiologists arrive at a more accurate diagnosis.