2.9. Ultrasound of Carotid and Vertebral Arteries
This protocol is extracted from research article:
Vertigo in Patients with Degenerative Cervical Myelopathy
J Clin Med, Jun 4, 2021; DOI: 10.3390/jcm10112496

All ultrasound examinations were performed by an experienced neurosonologist using advanced ultrasound equipment (Philips PureWave HD 15; Massachusetts, USA) with a 3–12 MHz multi-frequency ultrasound probe. Patients were examined in a supine position with the neck slightly extended. Arterial wall thickness was evaluated and any extracranial atherosclerosis and/or occlusive disease was detected, with particular attention to the carotid bifurcation. In the event of carotid stenosis, its severity was measured in B mode and colour mode, with complementary measurements of peak systolic flow velocity and diastolic velocity gauged by Doppler ultrasound, based on the European Carotid Surgery Trial criteria (70–99% stenosis was considered significant) [16]. Vertebral arteries (VAs) were visualised in a longitudinal plane at the sixth cervical vertebra, where the vertebral artery usually enters the transverse foramina. For analysis, the course of the VA was divided into two segments: Vertebral (V1) (from the origin of the vertebral artery until the point where it enters the fifth or sixth cervical vertebra) and V2 (the part of the vertebral artery that courses cranially to the transverse foramina until it emerges besides the lateral mass of the atlas) [17]. Each segment of the VA was studied in B mode and colour-code mode. Any stenotic lesions of the VAs were evaluated according to B mode and flow pattern. Criteria used for grading ≥50% stenosis were focal elevated blood flow velocity with a PSV cut-off point at the V1 segment of the vertebral artery of 140 cm/s, and 125 cm/s at the V2 segment [18].

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