Doppler Extra-Cranial Carotid Assessment, Protocols, and Interpretation

Over the past few decades, Doppler ultrasound has become a primary modality for extracranial carotid assessment because it is readily available, non-invasive, and relatively inexpensive. The sonographic evaluation of extracranial carotids is done for screening, diagnosis, and monitoring of atherosclerotic disease, as well as post-intervention analysis. The evaluation is crucial since the stroke risk increases with the degree of atherosclerotic narrowing leading to flow disturbances. Doppler imaging provides a quantitative assessment of velocity, which in combination with grayscale imaging provides a qualitative and quantitative assessment of plaque and stenosis. This is of utmost clinical importance for stroke risk stratification as well as providing indications for surgical intervention.