The utilization of carotid artery ultrasound in diagnosis of internal carotid artery absence and its imaging features

Abstract

Objective To explore diagnosis points of carotid artery ultrosound in patients of internal carotid artery (ICA) absence and other imaging features. Methods and Results Total 14 patients diagnosed with ICA absence in Tianjin Huanhu Hospital from January 2014 to May 2023 were retrospectively analyzed. Ten patients were male and 4 patients were female. The age of patients ranged from 13 to 79 years. Imaging exam: the CTA and (or) MRA of all patients showed absence of carotid canal, no development of the entire ICA, combined with intracranial vascular abnormalities. Eight of 14 patients had left ICA absence, 5 had right ICA absence, and one had bilateral ICA absence. According to collateral compensation LIE typing, 6 cases were type A, 2 cases were similar to type A with the existent of the A1 segment of ipsilateral anterior cerebral artery (ACA), 2 cases were type B, one case was type C, and one case was similar to type D as ipsilateral ACA was supplied by opposite through the anterior communicating artery, the ipsilateral middle cerebral artery (MCA) was supplied from the clinoid process of the contralateral ICA. Carotid artery ultrasound: all the 14 patients showed thin vessels in the extracranial segment of the common carotid artery (CCA) without bifurcation, which directly continued into external carotid artery (ECA), indicating the absence of one or both ICA absence; carotid artery bifurcation was not detected in multi⁃angle scanning of both 2D scan and color Doppler flow imaging, and the CCA directly continued into a single artery ECA with multiple branches; a "sawtooth" spectrum of the ipsilateral ECA was observed when tap the superficial temporal artery, which indicated that the artery was ECA; blood flow spectrum of the ipsilateral CCA was consistent with ipsilateral ECA. Conclusions Carotid artery ultrasound has high accuracy in the initial diagnosis of ICA absence. It is suitable for clinical application.

Keywords

• carotid artery, internal
• congenital abnormalities
• ultrasonography
• computed tomography angiography