A radiation-free screening method that uses sound waves to examine wall thickening, plaque, and percentage of narrowing in the main arteries of the neck.
Indication
- Transient vision loss, arm or leg weakness, or speech disturbance (suspected transient ischemic attack)
- Follow-up of patients with prior stroke or cerebrovascular disease
- A bruit heard on auscultation of the neck at rest
- Vascular disease risk factors such as advanced age, hypertension, diabetes, and hyperlipidemia
- Screening in smokers or those with a family history of early-onset vascular disease
- Follow-up after carotid surgery or stenting
- Vascular evaluation in the differential diagnosis of dizziness and syncope
Preparation
- No special preparation is needed; fasting is not required
- Comfortable clothing that exposes the neck area should be preferred
- Jewelry, necklaces, and scarves are removed before the examination
- Bringing prior Doppler, CT angiography, or MR reports facilitates comparison
How it's performed
- The patient is placed supine with the head turned slightly back and to the opposite side
- Gel that conducts sound waves is applied to the skin of the neck
- The probe is used to scan the common, internal, and external carotid arteries and the vertebral arteries on both sides
- Wall thickening (intima-media thickness, IMT) is measured
- Plaque presence, structure, and the percentage of stenosis it causes are evaluated using color and spectral Doppler
- Flow velocities are recorded; the procedure takes approximately 20-30 minutes
Post-procedure
- There are no restrictions after the procedure; daily life can resume immediately
- Results are evaluated together with a neurology or cardiology specialist
- If significant stenosis is present, confirmation by CT angiography or MR angiography is planned
- The treatment plan (medication, lifestyle, surgery/stent) is determined according to the degree of vascular narrowing
- Depending on risk factors, follow-up at 6-12 month intervals may be recommended
Risks
- Ultrasound does not contain ionizing radiation and has no known biological risk
- Very rare skin sensitivity related to the gel may occur
- Image quality may be limited in patients who are very obese or have a short neck
- Additional imaging may be needed to determine the precise percentage of high-grade stenosis
FAQ
Who should have a carotid Doppler?
It may be recommended for individuals with transient neurological findings, prior stroke, or vascular risk factors such as advanced age, hypertension, diabetes, smoking, or high cholesterol.
Is the procedure painful or harmful?
No. Ultrasound does not involve radiation and does not cause pain or discomfort.
What happens if plaque is detected?
The percentage of stenosis caused by the plaque is determined. Mild stenosis is managed with lifestyle changes and medication, while advanced stenosis is evaluated with additional imaging and, when necessary, surgery or stenting.
How long does it take to get the results?
The report is usually prepared the same day.
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