engleski

CDFI and PDI FINDINGS in EXTRACRANIAL ARTERY DISEASE

The development of duplex ultrasound instrumentation combining high-resolution B-mode imaging with Doppler flow analysis represents a major advancement in ultrasound cerebrovascular diagnosis. Duplex sonography enables not only estimation of artery stenosis, but allows the visualisation of the plaque morphology. The principal arterial abnormality detected with B-mode sonography is plaque, which appears as echogenic material that thickens the arterial wall and obliterates the lucent zone between the intimal reflection and the adventitia. When atherosclerotic plaque is detected, its severity, extent, morphology and location must be analysed. The most common site of atherosclerotic plaque formation is at the carotid bifurcation. The European Carotid Surgery Trial (ECST) and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) showed that the degree of ICA stenosis is a major predictor of ipsilateral ischaemic stroke in patients presenting with transient ischaemic attack or minor ischaemic stroke. The main location of vertebral stenosis or occlusion is the origin (V0 segment); less commonly more distal in the cervical region (V1 segment) or intracranially (V4 segment). The left subclavial artery is more often affected by atherosclerosis than truncus brachiocephalicus. The main characteristic of occlusion or stenosis of truncus brachiocephalicus are spectral changes in the right subclavial, carotid and vertebral artery. Cerebral ischemia is the most serious consequence of cervical artery dissection (CAD). The internal carotid artery is the most commonly affected vessel. In extreme cases, artery dissections can extend from the aorta, to subclavial, carotid and vertebral arteries. The term “vasculitis” encompasses a heterogeneous group of multisystemic disorders; CDFI examination demonstrates thickening of the arterial wall, usually circumferential, stenosis or occlusion of the arteries.

color Doppler; power Doppler; cerebrovascular disease

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