5 Quick Scanning Tips For Carotid Ultrasound

Scanning those tortuous Carotid vessels can sometimes be tricky! So here we'll go through 5 quick scanning tips to help you get great carotid images and accurate velocities. 

1. Do a Quick Scan Survey
Taking a quick look through the entire vessel and bifurcation before you start imaging will help you know of any plaque that might be present and will also help you be aware of the vessel course. This will help you better prepare to angle your Color & Doppler through any stenosis and also if there are tortuous vessels. It is always a good idea to know what you are getting yourself into first. 

2. Be Consistent
Often times your scanning protocol will be determined by the facility you work for. This is helpful with accreditation and standardization to make sure that accurate and consistent exams are performed every time, for every patient. With regard to protocol, it can sometimes be difficult to jump around from one vessel location, like proximal to the distal and then ECA and ICA and then go back to obtain it again for other imaging modes like Color and Spectral Doppler. So if at all possible, it is best to stay consistent, perform all imaging modes (2D, Color and PW Doppler) in that one location and then move on. 

3. Heel/Toe Will Come in Handy
Using the "Heel/Toe" method to rock and tilt the angle of the transducer will help to line up the vessel to the correct Doppler angle. This is especially useful when there is "deep dive" of the vessel or when there is a tortuous curve. By using your hand to angle the transducer, you can maintain that 60 degree angle and ensure that each Doppler sample is angled correctly. 

4. It's All About the Angle
Remember your Doppler angle should be parallel to blood flow through the vessel (not the vessel wall). This is important when there is a stenosis, because often the flow direction will change due to the shape of the plaque. Also, it's important to remember that the SVU recommends keeping your Doppler angle between 45-60 degrees in order to maintain consistency in reporting velocities. It can be helpful if you are doing a follow up study for a patient with a known stenosis to check the prior ultrasound images (not just the report) and review the Doppler angle used previously and where the stenosis was sampled. This can help to reduce errors between sonographers and ensure that the velocities reported are consistent and only different if there is truly a reduction in vessel lumen since the previous exam. 

5. Attention to Detail
Sometimes those tortuous vessels and deep vessels can be difficult. Pay attention to your PRF/scale, your wall filter settings and your color box angle. This can help bring in flow in those difficult exams. Often steering your color box straight will help to pick up those deep diving vessels. 

---

Get Our FREE SCANNING TIP DOWNLOAD

FREE DOWNLOAD