Threedimensional imaging of carotid arteries: Advantages and pitfalls of ultrasound investigations

To describe normal and pathological findings with three-dimensional (3D) ultrasound of the carotid bifurcation. Patients admitted to our ultrasound laboratory for vascular screening were submitted to standard carotid duplex and to 3D ultrasound reconstruction of the carotid bifurcation. Volume 3D scans were performed manually, on the axial plane, and the software presented the volume rendering from the inward blood flow signal detected with the Power Color Mode. Forty normal subjects, 7 patients with caliber alterations (4 carotid bulb ectasia and 3 internal carotid lumen narrowing), 45 patients with course variations (tortuosities and kinkings) and 35 patients with internal carotid artery stenosis of various degrees have been investigated. 3D ultrasound is a feasible technique. It can improve carotid axis general imaging through a global image presentation “at a glance”, visualizing caliber variations and vessels course. Imaging of stenosis from inward flow can be provided, but complete stenosis characterization requires the assessment of plaque morphology and vessel wall.