Echocontrast-enhanced ultrasound of extracranial internal carotid artery high-grade stenosis and occlusion

Abstract

Background and purpose: Proper assessment of extracranial internal carotid artery high-grade stenosis and occlusion by extracranial color-coded duplex sonography (ECCD) is occasionally made difficult by shadowing, an unfavorable insonation angle, low flow velocity or volume, or a deep insonation depth. In these cases, echocontrast could be helpful to quantify the degree of stenosis and to diagnose occlusion.

Methods: We investigated 17 arteries with poor precontrast investigation conditions and suspected high-grade stenosis or occlusion by contrast-enhanced ECCD.

Results: Compared with the precontrast scans, echocontrast allowed for significantly more segments to be evaluated by pulsed Doppler sonography (P<0.001) and for longer lumen segments to be displayed on color mode (P<0.001). Because it was now possible to place the sample volume right into the jet of the stenosis, the maximal flow velocity registered increased in all patients with stenosis.

Conclusions: Echocontrast-enhanced ECCD of the carotid arteries is helpful for stenosis classification in a small group of preselected patients with poor original examination conditions.