Precautions for doing B-ultrasound of neck blood vessels

Neck vascular B-ultrasound is a non-invasive examination method that can be used to detect diseases of the common carotid artery, internal carotid artery and external carotid artery. With the increasing number of patients with cardiovascular and cerebrovascular diseases, neck vascular B-ultrasound examination has become an indispensable diagnostic method. This article aims to introduce the precautions for neck vascular B-ultrasound examination and improve the accuracy and reliability of neck vascular B-ultrasound examination.

1. Patient Preparation

Ultrasound examination of the neck blood vessels generally does not require special preparation, such as fasting or holding urine. Patients need to be careful not to wear high-necked clothing, and it is better to wear tops with loose collars. Remove neck ornaments that may affect the examination in advance, do not engage in strenuous exercise before the examination, and inform the doctor before the examination if there is obvious pain in the neck to avoid pressing the neck blood vessels during the examination to cause discomfort.

2. Inspection content and posture

The patient lies flat or on his side on the examination bed, tilts his head back slightly to expose his neck. The examination includes the bilateral common carotid arteries, internal carotid arteries, external carotid arteries and vertebral arteries. During the examination, the carotid artery is examined section by section from the proximal end to the distal end.

First, observe whether the carotid artery wall has clear layers. Under normal circumstances, the carotid artery wall should present a clear layered structure, including the intima, middle layer and adventitia, and each layer should have a clear boundary.

Secondly, observe whether the intima-media thickening of the vessel wall is present. Intima-media thickening may be a manifestation of atherosclerosis, which can lead to stenosis of the vessel lumen and may cause changes in blood flow velocity.

Finally, observe whether there is a sclerotic plaque. A sclerotic plaque is formed by lipid deposition, fibrosis and calcium salt deposition on the blood vessel wall. In the B-ultrasound image of the neck vessels, a sclerotic plaque usually appears as an area with increased echoes and irregular shapes, which can show the location, shape and size of the plaque.

3. Matters needing attention during the inspection

Reduces motion and movement from breathing, which can cause blood vessels to move and deform, blurring the image.

Avoid obstructions to the head and neck such as buckles, ties, etc., which can interfere with image quality and lead to inaccurate examination results.

Follow standard procedures during examination and adopt unified examination methods and procedures to reduce misdiagnosis and missed diagnosis rates.

4. How to read the carotid ultrasound report

Generally speaking, the carotid ultrasound report is divided into 3 parts:

Specific values: Includes various specific numerical measurements, such as vascular inner diameter, intimal thickness, blood flow velocity and resistance, etc., providing information on vascular structure and function.

Specific description: Provides a more detailed description, including whether the vascular endothelium is hardened, whether plaques are found, whether there is thrush, etc., to help doctors further evaluate the vascular lesions.

Report conclusions: Common conclusions include normal, manifestations of carotid artery sclerosis, carotid artery sclerosis combined with plaque formation, carotid artery stenosis or even complete occlusion, etc., providing concise evaluation report results.

Carotid Intima-Media Thickness (IMT):

Generally, it does not exceed 0.10cm. If it exceeds 0.10cm and is less than 0.15cm, it is called intima-media thickening, which is the early manifestation of atherosclerosis. Generally, it thickens with age. If it exceeds 0.15cm, atherosclerotic plaque formation is considered.

Carotid artery stenosis degree:

The degree of stenosis is generally expressed as a percentage (%). Less than 50% is mild stenosis, and greater than 50% is severe and requires timely treatment.

Plaque Echo:

Low echoes represent soft plaques, high echoes belong to hard plaques, mixed echoes and equal echoes are between hard and soft plaques, and echoes of varying strengths belong to ulcerative mixed plaques.

Arterial diameter and blood flow velocity:

Intima-medial diameter (IMD): The report usually provides a measurement of the intima-media diameter of the carotid artery. A larger intima-media diameter may indicate abnormalities in the blood vessel wall.

Peak flow velocity (PSV) and mean flow velocity (EDV): These values ​​are used to estimate blood flow rate; increased flow may indicate arterial narrowing.

Arterial blood flow direction and hemodynamics:

Directionality: The test report will indicate the direction of blood flow, including forward (normal) or reverse (abnormal) flow.

Segmental flow and pulsatility: Segmental flow and pulsatility can detect abnormalities in the vessel wall or arteriosclerosis.

The tube diameter, blood flow velocity and other hemodynamic parameters need to be interpreted by professional doctors and are difficult for patients to understand on their own.

This article introduces the preparations for B-ultrasound examination of the neck vessels, the content and posture of the examination, matters that need to be paid attention to during the examination, and the interpretation and analysis of the report. It is hoped that it will promote readers' in-depth understanding of B-ultrasound of the neck. It should be noted that if carotid artery plaques are detected, do not abuse drugs on your own. Consult a doctor in time and receive treatment according to the doctor's advice.

The views expressed in this article are personal. If you have any questions or doubts, please consult a professional medical professional. (Huang Min, Lingshou County People's Hospital, Shijiazhuang City, Hebei Province)