Ultrasonic features of extracranial carotid dissections: 47 cases studied by angiography.

Abstract

The purpose of this prospective study was to assess the value of continuous wave Doppler velocimetry, standard duplex scanning and color Doppler flow imaging in the diagnosis of carotid dissections. From 1975 to 1993, 42 patients (mean age, 44 +/‐ 14 years) were admitted to the University Hospital of Angers for a carotid dissection studied first by ultrasonography, then defined by angiography. Five cases were bilateral. Continuous wave Doppler examination revealed signs of severe obstruction of the carotid arteries in 96% of the cases (occlusion, extensive submandibular tight stenoses, significant slowdowns in the carotid and ophthalmic vessels, retrograde ophthalmic blood flow). Standard duplex scanning suggested dissection in 72% of the cases (tapering stenoses or occlusion, segmental ectasis, tubular vessel, peripheral residual channel, or rare irregular "membrane"). Color Doppler flow imaging suggested a dissection in 82% of the cases. This method has the advantage of underlining the peripheral channel, the double lumen, and the dissecting hematoma, which often is hypoechoic. The ultrasonic methods (continuous wave Doppler combined with color Doppler flow imaging) failed only when they are performed late and when moderate or segmental intrapetrosal dissections were present. These ultrasonic investigations would thus appear to be useful for early diagnosis of carotid dissections.

Dissecção espontânea cervical carotídea e verbal: estudo de 48 pacientes

“…Entretanto esta seqüência apresenta algumas limitações: se o hematoma for recente (alguns dias) poderá não apresentar hipersinal e se for antigo (meses) o hematoma já poderá ter sido absorvido e não apresentar mais o hipersinal.Além disso, quando há hipersinal preenchendo toda a luz da artéria, a diferenciação entre hematoma intramural e trombo pode ser difícil 41 . Quanto ao ultra-som Doppler das artérias carótidas e vertebrais, embora possa ser útil numa avaliação inicial, alterações específicas como a visualização do hematoma intramural ou do "flap" intimal são encontrados em menos de 30% dos exames 42 , tornando quase obrigatória a complementação da investigação com AD ou RM, principalmente nos casos vertebrais, em que a sensibilidade desse método é menor.…”

Fibromuscular Dysplasia: State of the Science and Critical Unanswered Questions

“…[151][152][153] For complete evaluation for carotid or vertebral artery dissection, CTA and MRA are the preferred modalities.…”

Extracranial traumatic carotid artery dissections in children: a review of current diagnosis and treatment options

“…Authors of small series only have reported the use of ultrasonography in the diagnosis and follow-up of CADs. 10,60,64,67,71 Duplex ultrasonography provides high-resolution real-time images of the CA bifurcation and proximal internal CA and has proved reliable in evaluating the presence and severity of atherosclerotic disease. Ultrasonography is noninvasive and more widely available than conventional angiography or MR angiography.…”