Color Doppler Ultrasound of Carotid and Vertebral Vessels: Anatomy, Technique and Reporting

  • Mehrzad Lotfi Department of radiology, medical imaging research center, Shiraz University of Medical Sciences.
Keywords: Color Doppler Sonography, Carotid, Vertebral, Stroke, Stenosis


Color Doppler study of carotid and vertebral arteries is a non-invasive, reliable and also easily available, cost-effective method for screening and follows up of patients at risk of stroke to differentiate patients need surgery or intervention from whom could be followed by medical management. I   reviewed anatomy of cervical arteries and different techniques such as B- mode or gray scale scanning, color flow mapping and spectral analysis for evaluation of both carotid and vertebral arteries.


Borhani Haghighi A, Yousefi S, Bahramali E, Kokabi S, Heydari ST, Shariat A, et al. Demographic and Technical Risk Factors of 30-Day Stroke, Myocardial Infarction, and/or Death in Standard-and High-Risk Patients Who Underwent Carotid Angioplasty and Stenting. Interventional neurology. 2014;3(3-4):165-73.

Borhani-Haghighi A, Safari R, Heydari ST, Soleimani F, Sharifian M, Kashkuli SY, et al. Hospital mortality associated with stroke in southern iran. Iranian journal of medical sciences. 2013 ;38(4):314-20.

Eliasziw M, Rankin RN, Fox AJ, Haynes RB, Barnett HJ, North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group. Accuracy and prognostic consequences of ultrasonography in identifying severe carotid artery stenosis. Stroke. 1995;26(10):1747-52.

Hunink MG, Polak JF, Barlan MM, O'leary DH. Detection and quantification of carotid artery stenosis: efficacy of various Doppler velocity parameters. AJR. American journal of roentgenology. 1993;160(3):619-25.

Polak JF, Dobkin GR, O'leary DH, Wang AM, Cutler SS. Internal carotid artery stenosis: accuracy and reproducibility of color-Doppler-assisted duplex imaging. Radiology. 1989 ;173(3):793-8.

Gaitini D, Soudack M. Diagnosing Carotid Stenosis by Doppler Sonography State of the Art. Journal of ultrasound in medicine. 2005 ;24(8):1127-36.

Maggi P, Lillo A, Perilli F, Maserati R, Chirianni A, PREVALEAT Group. Colour-Doppler ultrasonography of carotid vessels in patients treated with antiretroviral therapy: a comparative study. Aids. 2004 ;18(7):1023-8.

Thrush A, Hartshorne T. Vascular Ultrasound: How, why and when. Elsevier Health Sciences; 2009.

Jahromi AS, Cinà CS, Liu Y, Clase CM. Sensitivity and specificity of color duplex ultrasound measurement in the estimation of internal carotid artery stenosis: a systematic review and meta-analysis. Journal of vascular surgery. 2005 ;41(6):962-72.

Dinkel HP, Moll R, Debus S. Colour flow Doppler ultrasound of the carotid bifurcation: can it replace routine angiography before carotid endarterectomy?. The British journal of radiology. 2001 ;74(883):590-4.

von Sarnowski B, Schminke U, Tatlisumak T, Putaala J, Grittner U, Kaps M, et al. Prevalence of stenoses and occlusions of brain-supplying arteries in young stroke patients. Neurology. 2013 ;80(14):1287-94.

European Carotid Surgery Trialists' Collaborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). The Lancet. 1998 ;351(9113):1379-87.

Allan PL. Clinical doppler ultrasound. Elsevier Health Sciences; 2006.

Cloud GC, Markus HS. Diagnosis and management of vertebral artery stenosis. Qjm. 2003 ;96(1):27-54.

Buckenham TM, Wright IA. Ultrasound of the extracranial vertebral artery. The British journal of radiology. 2014 .

Goray VB, Joshi AR, Garg A, Merchant S, Yadav B, Maheshwari P. Aortic arch variation: a unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery. American journal of neuroradiology. 2005 ;26(1):93-5.

Lotfi M, Nabavizadeh SA, Foroughi AA. Aortic arch vessel anomalies associated with persistent trigeminal artery. Clinical imaging. 2012;36(3):218-20.

Grønholdt ML, Nordestgaard BG, Schroeder TV, Vorstrup S, Sillesen H. Ultrasonic echolucent carotid plaques predict future strokes. Circulation. 2001 ;104(1):68-73.

Steinke W, Meairs S, Ries S, Hennerici M. Sonographic assessment of carotid artery stenosis comparison of power Doppler imaging and color Doppler flow imaging. Stroke. 1996 ;27(1):91-4.

Koga M, Kimura K, Minematsu K, Yamaguchi T. Diagnosis of internal carotid artery stenosis greater than 70% with power Doppler duplex sonography. American journal of neuroradiology. 2001 ;22(2):413-7.

Sztajzel R. Ultrasonographic assessment of the morphological characteristics of the carotid plaque. Swiss medical weekly. 2005 ;135(43/44):635.

Schöning M, Walter J, Scheel P. Estimation of cerebral blood flow through color duplex sonography of the carotid and vertebral arteries in healthy adults. Stroke. 1994 ;25(1):17-22.

Thiele BL, Jones AM, Hobson RW, Bandyk DF, Baker WH, Sumner DS, et al. Standards in noninvasive cerebrovascular testing. Report from the committee on standards for noninvasive vascular testing of the joint council of the society for vascular surgery and the north American chapter of the international society for cardiovascular surgery. Journal of vascular surgery. 1992 ;15(3):495-503.

Soulez G, Therasse E, Robillard P, Fontaine A, Denbow N, Bourgouin P, et al. The value of internal carotid systolic velocity ratio for assessing carotid artery stenosis with Doppler sonography. AJR. American journal of roentgenology. 1999 ;172(1):207-12.

Wardlaw JM, Lewis S. Carotid stenosis measurement on colour Doppler ultrasound: agreement of ECST, NASCET and CCA methods applied to ultrasound with intra-arterial angiographic stenosis measurement. European journal of radiology. 2005;56(2):205-11.

Oates CP, Naylor AR, Hartshorne T, Charles SM, Fail T, Humphries K, et al. Joint recommendations for reporting carotid ultrasound investigations in the United Kingdom. European Journal of Vascular and Endovascular Surgery. 2009 ;37(3):251-61.

Njemanze PC, Beck OJ, Gomez CR, Horenstein S, Cujec B, Polasek P, et al. North american symptomatic carotid endarterectomy trial. Methods, patient characteristics, and progress. Stroke. 1991;22(6):711-20.

Grant EG, Benson CB, Moneta GL, Alexandrov AV, Baker JD, Bluth EI, et al. Carotid Artery Stenosis: Gray-Scale and Doppler US Diagnosis—Society of Radiologists in Ultrasound Consensus Conference 1. Radiology. 2003;229(2):340-6.

McGahan JP, Goldberg BB. Diagnostic ultrasound. Informa Health Care; 2008.

Rohren EM, Kliewer MA, Carroll BA, Hertzberg BS. A spectrum of Doppler waveforms in the carotid and vertebral arteries. American Journal of Roentgenology. 2003 ;181(6):1695-704.

How to Cite
Lotfi, M. (2016). Color Doppler Ultrasound of Carotid and Vertebral Vessels: Anatomy, Technique and Reporting. Galen Medical Journal, 5(S1), 24-35.