Doppler ultrasonography of cervical arteries

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Overview

Arteries supplying the brain with blood pass through the cervical region (neck). At this level they are easily explored with ultrasound.

These arteries are the two internal carotid arteries (right and left) supplying the most part of the brain in its anterior portion (front) and the two vertebral arteries (right and left) to irrigate the posterior (rear) of the brain, the cerebellum (small brain) and brainstem (the portion of the nervous system that connects the spinal cord and brain).

By using ultrasound, the doctor can view and explore the cervical region and common carotid arteries, external carotid and subclavian arteries.


Contents

1. Overview
2. Ultrasonic exploration method
3. Doppler ultrasound imaging


Ultrasonic exploration method

Ultrasonic exploration method is based on the receipt by the ultrasound device of the echoes emitted by the explored anatomical structures after their contact with the waves emitted by the device’s probe.

As the name suggest, this technology uses ultrasound waves that are vibrating at a frequency higher than sounds (ultrasound inaudible to the human ear). Waves are emitted and received by the device ultrasound probe; the probe contains piezoelectric crystals that vibrate in contact with a weak electrical current.

Anatomical structures, to which ultrasound are sent, can absorb these (eg soft structures, fluid or fat), they may reflect, sending back echoes, or they may spread.

The device analyzes the ultrasound echoes from anatomic structures and creates a real-time image of these structures.

In our case, we can see blood vessels (arteries or veins), we see the walls of these vessels, we can see also the deposition of cholesterol in the arteries (atherosclerotic plaques) and we can see if blood vessel is narrowed (stenosed) or occluded by blood clots.

Also, you can see if the cholesterol and fat deposits on artery walls have a dangerous character, that have high risk of forming blood clots in their area that can block arteries and cause serious damage. These images are two-dimensional ultrasound.

But the device can also analyze the echoes emitted by moving blood column through arteries or veins. On basis of this analysis is the phenomenon effect described by nineteenth-century Austrian physicist Christian Doppler (frequency variation of a wave emitted or reflected by an object moving against a stationary receiver). Therefore, the method is called Doppler.

With this method you can highlight blood flow velocity, how the arteries blood flow (smooth flow, laminar flow with vortices, with turbulence etc.).

The device highlights the blood flow using the sounds and images. Images are either a graph of speeds, or color form occurring within the artery image showing directly how blood flows.


Doppler ultrasound imaging

Doppler ultrasound of cervical vessels may show the status of vessels, the degree of atherosclerosis and risk of stroke, stenosis (narrowing) of these vessels or occlusion (blockage) of these vessels, if any dangerous plaque buildup, the risk of stroke or if there are thrombi (clots) in the arteries or if there is a dissection (splitting) of the blood vessel wall.

Doppler ultrasound can identify whether the risk of stroke or even source, the arterial cause of a stroke.

Thus, this method allows orientation to drug treatment, or sometimes to the surgery (artery enlargement through surgery) or catheter intervention (balloon probe is inserted into the artery, the balloon inflates, widens the artery and then let there be a net metal, which is a stent that prevents vessel re-obstruction).

If you can see thickening of the arteries in the neck, or if it reveals plaque buildup (deposits of fat and cholesterol) in these walls, this is a warning sign for heart vessels, coronary arteries, which can present similar changes and there is risk of myocardial infarction.

In conclusion, Doppler ultrasonography of cervical arteries is a simple, free of dangers for the patient, and can give much information about the patient’s arteries and about how blood circulates through the arteries, highlighting the risk of stroke, or the cause of a stroke, or firing a warning about the risk of myocardial infarction.

This method is very useful for determining appropriate treatment, medication, and sometimes surgical intervention.

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