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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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1.12.1\ Scanning Method

After showing the longitudinal section of the common carotid artery, the transducer is moved to scan posterolaterally, looking for a transverse process of the cervical vertebra (discontinuous arrangement of highly echogenic reflectors with clear shadows) and showing the upper longitudinal section of the vertebral artery which is traveling in the vertebral transverse processes.

1.12.2\ Sectional Structure

The middle segments of the vertebral artery and vertebral vein are displayed. The vertebral vein is anterior to the vertebral artery, the latter is usually located at internal-posterior to the VV.

1.12.3\ Measurement Methods

The diameter and the velocity of the vertebral artery are measured.

1.12.4\ Clinical Significance

The anatomical location of the mid-upper vertebral artery can be shown and the stenosis or occlusion of the vertebral artery diagnosed by this section. The change of the vertebral artery blood flow spectrum is an important basis for the diagnosis of subclavian steal syndrome.

1.12.5\ Note

The diameters of the left and right vertebral artery are different in most cases: the left side is greater than that of the right side.

7  Vascular System Scanning

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1.13\ Longitudinal Scanning

of the Middle Segment

of the Vertebral Artery Using

Color Flow Imaging

Fig. 7.13  Longitudinal section of the middle segment of the vertebral artery using color flow imaging

RVA

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1.13.1\ Scanning Method

After showing the longitudinal section of the common carotid artery, the transducer is moved to scan posterolaterally to look for a transverse process of the cervical vertebra (discontinuous arrangement of highly echogenic reflectors with clear shadows), or after showing the proximal segment of the vertebral artery, the probe is moved up to show the longitudinal section of the mid-upper segment of the vertebral artery. The scale size of color Doppler is very important and generally is set 10–13 cm/s. The individual difference of the vertebral artery is relatively larger; in normal, the lumen should be filled with blood flow signal without spillover.

1.13.2\ Sectional Structure

The long axis view of the middle of the vertebral artery and vertebral vein which locates anterior to the vertebral artery and parallel to it. The low-­

velocity blood flow signal in the front comes from the vertebral vein, and the high-velocity blood flow signal posteromedial comes from the vertebral artery.

1.13.3\ Measurement Methods

The diameter and the blood flow spectrum of the vertebral artery measured.

1.13.4\ Clinical Significance

Two-dimensional ultrasound on the display of the vertebral artery is different, especially the endometrial display is not clear enough. Generally, it is necessary to use color Doppler ultrasound to track the artery, according to the shape of flow, to estimate whether there is lumen stenosis or ­occlusion. So color Doppler ultrasound is the necessary means of checking. The middle of the vertebral artery rarely produces intimal thickness due to atherosclerosis.

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1.14\ Pulsed-Doppler Spectrum

of the Vertebral Artery

Fig. 7.14  Pulsed-­ Doppler spectrum of the vertebral artery

1.14.1\ Scanning Method

The subject takes a supine position with the head slightly stretched to make a full extension of the neck. The head holds the middle position or turns to the opposite side when one side of the common carotid artery is examined. The probe is put on the lateral or post-lateral neck, and longitudinal scanning is performed from bottom to top.

1.14.2\ Sectional Structure

The longitudinal section of the proximal or middle segment and the blood flow spectrum of the vertebral artery are shown.

1.14.3\ Measurement Methods

Under the guidance of color Doppler, the pulse-­ Doppler sampling volume is placed in the center

of the proximal segment or middle segment of the vertebral artery. It can also be placed in the brightest point of the color blood flow signal. The Doppler beam angle correction of θ line parallels to the beam flow line as far as possible, and the angle should be no more than 60°.

1.14.4\ Clinical Significance

The normal range of flow velocity of the bilateral vertebral arteries is large. The vertebral artery spectrum may have significant changes before the clinical symptoms; a slight change of the flow spectrum in the vertebral artery may not have corresponding symptoms. Peak blood flow velocity increases by age.

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2\ Arteries of the Upper

Extremity

2.1\ Longitudinal Scanning

of the Left Subclavian Artery

Fig. 7.15  Longitudinal section of the left subclavian artery

LCCA

LSCA

AAr