Page 85 - Libro 2

5
Uncommon Pathology of the Carotid System
Eileen French-Sherry
OBJECTIVES
KEY TERMS
aneurysm | arteritis | carotid body tumor | dissection | fibromuscular dysplasia | intimal flap | pseudoaneurysm | radiation injury | tortuosity
GLOSSARY
aneurysm a localized dilatation of the wall of an artery
arteritis inflammation of an artery
carotid body tumor a benign mass (also called paraganglioma or chemodectoma) of the carotid body, which is a small round mass at the carotid bifurcation
dissection a tear along the inner layer of an artery that results in the splitting or separation of the walls of a blood vessel
fibromuscular dysplasia abnormal growth and development of the muscular layer of an artery
Atherosclerosis is clearly the most common pathol- ogy that is encountered during a carotid ultrasound examination. However, the vascular sonographer will be faced with other forms of disease and abnor- malities while scanning the carotid arteries. Some of these abnormalities will be observed more frequent- ly, such as tortuosity, whereas others are fairly rare, such as a carotid artery aneurysm. It is important to know the ultrasound presentation and scanning re- quirements when presented with nonatherosclerotic
wall with fibrosis and collagen deposition causing stenosis
intimal flap a small tear in the wall of a blood vessel resulting in a portion of the intima and part of the media protruding into the lumen of the ves- sel; this free portion of the blood vessel wall may appear to move with pulsations in flow
pseudoaneurysm a dilation of an artery with disruption of one or more layers of the vessel wall causing an expanding hematoma; also called false aneurysm
tortuosity the quality of being tortuous, winding, twisting
carotid disease. This chapter will review several of these less common findings observed during carotid duplex scans.
TORTUOSITY AND KINKING
Sonographers frequently encounter tortuous carotid arteries with varying degrees of winding and bend- ing. Some of these vessels will be kinked with a
Recognize patient signs and symptoms of carotid artery pathology beyond atherosclerosis
Identify uncommon pathology in the carotid arteries
Plan an appropriate duplex exam to assist in the diagnosis of unusual pathology in the carotid arteries
Create interpretable images of unusual carotid pathology using B-mode, Doppler, and color duplex ultrasound techniques
Avoid pitfalls in scanning and documenting unusual pathology in the carotid arteries
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