Extrakranielle Farbduplexsonografie hirnversorgender Arterien

Zusammenfassung

Die Ultraschalldiagnostik der extrakraniellen hirnversorgenden Arterien spielt eine zentrale Rolle bei der Stratifizierung des Risikos für zerebrovaskuläre Ereignisse und für das Erkennen von Ursachen eingetretener Hirninfarkte. In dieser Übersicht werden neben etablierten Befunden Ergebnisse neuerer Arbeiten vorgestellt, die insbesondere Bedeutung für den täglichen Einsatz der sonografischen Diagnostik haben. Es wird auf die Technik und Relevanz der Messung der Intima Media-Dicke und die Signifikanz der Echomorphologie atherosklerotischer Plaques der carotis eingegangen, zudem werden die neuen sonografischen Kriterien der Klassifikation von Karotisstenosen eingehend dargestellt, die 2010 publiziert wurde und zunehmend verwendet wird. Im letzten Teil werden typische Befunde bei Dissektionen der extrakraniellen Arterien gezeigt und dabei insbesondere auf die Unterschiede von Dissektionen der A. carotis interna und communis hingewiesen.

Summary

Diagnostic ultrasound of the extracranial brain supplying arteries plays a central role in the risk stratification of cerebrovascular events and the assessment of the causes of brain infarction. In this review, new study results and current sonographic standards are presented with particular view of the application in daily ultrasound studies. Technique and relevance of the measurement of intimamedia-thickness and the significance of the ultrasound appearance of atherosclerotic plaques are discussed. In addition, new sonographic criteria for the classification of carotid stenosis, published in 2010 and increasingly applied, are presented. In the final section, typical ultrasound findings of dissections of the extracranial arteries are demonstrated and the difference between dissections of the internal and common carotid artery, respectively, are considered.

Schlüsselwörter

Ultraschall - Intima-Media-Dicke - Atherosklerose - Karotisstenose - Dissektion

Keywords

Ultrasound - intima-media-thickness - atherosclerosis - carotid artery stenosis - dissection

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