High definition imaging of carotid arteries using a standard commercial ultrasound “B” scanner. A preliminary report

Sixteen carotid arteries in nine patients with transient ischaemic attacks and carotid bruits were examined by direct scanning grey scale ultrasound using a 10 HMz probe attached to a standard commercial apparatus. Findings using ultrasound were compared with a contrast arteriogram performed on the following day and, in two cases, with the surgical appearances during endarterectomy. Atheromatous plaques were demonstrated in five common carotid arteries by ultrasound. Arteriography failed to show proximal plaques in two common carotid arteries and extension of bifurcation disease into the adjacent common carotid in a third patient. Ultrasound detected four stenotic and one occluded internal carotid artery. One internal carotid artery with a 25% stenosis was shown by arteriography but not by ultrasound. Of the five external carotid stenoses, one with a minimal stenosis of less than 10% was not demonstrated. In all cases, stenoses in excess of 30% were shown by ultrasound. Surgical findings correlated more closely with details of the plaques as shown by ultrasound than by arteriography. It is suggested that ultrasound might be used to pre-select reliably those patients who would benefit from a contrast arteriogram and, thus, to protect those with normal carotid arteries from a potentially hazardous invasive investigation.