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Carotid Ultrasound (last edited 08/07/2018)
(last reviewed 08/07/2018)

Carotids:  Sagittal and transverse gray scale.  Duplex Doppler interrogation of CCA, ECA, ICA.  Color Doppler to look for areas of stenosis (narrowing by plaque, turbulence)


  1. Trans Prox CCA
  2. Trans Mid CCA
  3. Trans Dist CCA
  4. Trans Bulb
  5. Tran Bifurcation
  6. Sag Prox/Mid CCA gray scale, color, and Doppler
  7. Sag Distal CCA gray scale, color, and Doppler
  8. Sag  Bulb gray scale, color, and Doppler
  9. Sag ICA Gray scale and color
  10. Sag  Prox ICA gray scale, color, and Doppler
  11. Sag Mid ICA gray scale, color, and Doppler
  12. Sag Distal ICA gray scale, color, and Doppler
  13. Sag ECA  gray scale, color, and Doppler
  14. Sag Vertebral Color and Doppler

Start exam on RIGHT side, then do LEFT side

A gray scale transverse image of the vessel is required to demonstrate area of excessive plaque.

Use color Doppler to examine CCA, Bulb, ICA, ECA for identifying turbulence or narrowing of lumen by plaque.  If narrowing not visible on gray scale images, provide color Doppler images (sag and trv) of this area.  If an area of turbulence or narrowing is noted, then also Duplex Doppler that particular area.  

Notes:  Duplex Doppler - align the angle to be as parallel as possible to the vessel.  the angle should be as small as possible while still remaining parallel to the vessel and not to exceed 60 degrees.