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Ultrasound tests use sound waves to create images of the internal organs. Carotid ultrasounds are usually ordered to evaluate the flow in the vessels of your neck that supply blood to your neck, face and brain.

In the carotid picture to the right, the vessel is the tubular structure that is filled with color. The color is the ultrasound machine's intrepretation of the flow of blood. The gray wave at the bottom is the pulsation of the vessel.

Your carotid arteries are located along the sides of your neck.  If you have atherosclerosis (aka plaque formation) of your vessels it will show up as areas of narrowing or irregularity. Plaque can result in stenosis (aka narrowing) of the vessel which can lead to decreased flow to the brain for example.

Plaque can also completely block the flow of blood. Some patients with blocked vessels may have no to few symptoms because the blockage has occurred slowly over time and they have collateral vessels that bypass the blockage and supply blood to critical brain structures. However, other patients may exhibit symptoms such as small strokes, dizziness, vertigo, passing out etc. Plaque can also break off and travel up into the brain and cause a stroke.  

Your doctor's order may read "r/o stenosis", "h/o TIA" or "stroke", for example.

(FYI "r/o" stands for rule out, "h/o" stands for history of, and TIA is transient ischemic attack)

Below are some common indications for carotid ultrasounds.

• Examine vessels for narrowing due to symptoms related to stroke, narrowing or blockage
• Examine the vessels due to comorbid medical conditions such as diabetes, high cholesterol or family history of stroke
• Evaluate the vessels because of a bruit (rushing, whistling noise) of the vessels heard during a physical exam
• Preoperative evaluation for carotid or other vascular surgery such as heart surgery
• Follow up carotid surgery and evaluate for any progression/worsening of narrowing
• Look for injury to the vessel (dissection, hematoma, etc)

Below is a brief outline of the procedure.

1. After you sign in to the Radiology office, you'll be taken to the ultrasound room.
2. An ultrasound technician will perform the test.
3. Once you enter the room, you will lie down on a bed/gurney.
4. The technologist will ask you to pull down your collar or loosen your shirt.
5. He or she will place a a warmed gel solution over the skin of your neck.
6. The technologist will use an ultrasound probe and glide it over the neck and take pictures.
7. You may be asked to turn your head for the technologist to get a better look at the vessels in the neck.
8. The technologist may ask the Radiologist doctor to review the scan before you leave.
9. An official report is generated by the Radiologist in about 24-48 hours.

If you are insured carotid ultrasounds are covered. However, for uninsured patients these tests can be quite expensive. You can expect to pay anywhere between $300 and $700 for this test.

Have you had a carotid ultrasound? What was it like? Please leave your comments below: