Color Doppler Ultrasound Examination Of Carotid Artery And Applied Anatomy Study

Purpose Color Doppler Ultrasound has been widely used to examine the carotid artery. This method provides not only real-time information but also the low cost, minimal risk and accuracy. This study aimed to determine the correlation between the carotid bifurcation and the angle of the mandible and the up edge of thyroid cartilage . On the other hand , knowing the normal imaging anatomy of common carotid artery bifurcation(CCAB) and its variations is important , at the same time , knowing the correlative sites of original segment of internal carotid artery(ICA) and external carotid artery(ECA) can be useful for planning and conducting the operation of head , neck and face . This study determined the correlation of in real-time ultrasound measurements of intima-media thickening (IMT), lumen diameter of the common carotidartery (CCA) with corresponding measurements obtained by gross pathology ; and this study provides credibility anatomic date and hemodynamic information for clinical diagnosis and prediction of cerebrovascular disease and ischemic heart disease.Material and Method 180 subjects with no history of hypertension , diabetesmellitus , atherosclerotic disease , smoking , high cholesterol , obesity were divided into three groups based on three ages : 20-39 years , 40-59 years, >60 years . All studies were performed with the patients lying face-up on the examining bed with their necks extended 45 toward the head of the bed and rotated 45 away from the examiner. 2D image view the anatomy of blood vessel , height of carotid bifurcation and the correlation sites of original segment of ICA and ECA . The internal diameter , intima-medial wall thickness(IMT) in CCA and in bifurcation ,peak systolic velocity(SPV) , end diastolic velocity(EDV) , resistance index(RI) and pulse index(PI) were measured by Doppler . 32 cadavers were poisoned in the same fashion as the preoperative duplex studies as soon as possible . After the common carotid artery and its major branches were exposed , the distances between the carotid bifurcation and the angle of the mandible and the up edge of thyroid cartilage were measured . And then excising the carotid artery including CCA, ECA and ICA , measuring the lumen perimeter and IMT after decalcification , at last , calculating the diameter of a circle with a circumference equal to the measured perimeter . The obtained data were treated statistically by the SPSS Microsoft and expressed with the average and standard deviation .Results ( 1) . The mean distance from the carotid bifurcation to the angle of the mandible is 3.67+0.83cm , the bilateral CCABs were at the same level in 88.89% of cases and 11.11% of cases were not . The most common position(229/360,63.6%) of ECA was anteromedial to ICA ,of which the left side amount to 75% while the right side amount to 52.2% with significant difference(p<0.05) . (2). We obtained the correlation of the carotid bifurcation with the up edge of thyroid cartilage , the same level , over or under the up edge of thyroid cartilage occurred in 37.5% , 53.% , 9.4% of the cases , respectively . And mean measurements between the CCAB and the angle of the mandible were 30.6+5.1mm . (3). In the present study , values for lumen diameter obtained by ultrasound were generally larger than those obtained by pathology , and ultrasound measurements of the IMT were smaller , this discrepancy was presumably due to various types of artificial distortion of the specimens , the presence of slit-like and occluded lumens that were likely related to loss of perfusion pressure, and an inability to match planes of interrogation used in B-mode ultrasonography with pathology planes contributed significantly to the existence of mismatches. On the other hand , fixation and decalcification produced minimal and insignificant distortional changes . (4). We obtained the average and standard deviation of hemodynamic date on right and left carotid of males and females. Diameter and IMTincreased with the age , flow velocity decreased with the age . Conclution (1). Duplex ultrasoun...