When carotid ultrasound find plaque, what to do

 

More and more middle-aged and older people are beginning to pay attention to their own health. Many company will organize medical examinations, and the people sometimes go to the hospital to do individual inspections. In recent years, it has been very common to detect diabetes, high blood pressure and high blood fat during physical examination. This is what people often call "three highs". A common feature of these diseases is that they involve the blood supply pathway of the human body - arteries, to the hospital for examination, usually doctors. It is recommended to do vascular ultrasound. The most representative artery is the cervical artery vascular ultrasound. Therefore, carotid ultrasound is the most important first choice. Color Doppler ultrasound is the safest, most convenient and cheap means to check blood vessels. As an ultrasound doctor, plaques in the arteries can be clearly visualized by cervical ultrasound. These plaques, like autumn leaves, fall onto the vasospasm and can be seen everywhere. Many middle-aged and older people are worried and panic, seeking medical treatment everywhere, which cause over-examination and over-treatment. Then, what kind of plaque needs follow-up observation, what kind of plaque needs treatment? It is a good thing for the people to pay attention to health, but to help the people understand the significance of carotid ultrasound examination, it is one of the doctor's duties to take less detours.

 

First, what can the neck vascular ultrasound check?

Cervical vascular ultrasound can examine multiple vessels in the neck, the innominate artery from the heart, the bilateral subclavian artery, the bilateral vertebral artery, the bilateral common carotid artery, the internal carotid artery, the external carotid artery, and the cervical vascular ultrasound. Clearly showing the diameter, intima-media thickness, plaque size, location, and morphology of these vessels, the flow velocity of the artery can be accurately measured. Among these vessels, the internal carotid artery is the most important, and the internal carotid artery is divided into left and right sides. Supply the majority of the left and right cerebral hemispheres (front 2/3). Cervical vascular ultrasound can be examined for diseases: the most common disease is atherosclerosis of the neck vessels, including the formation of arterial plaques, severe vascular stenosis or even occlusion, leading to cerebral infarction.

 

Second, how is carotid plaque formed?

Atherosclerosis is a complex process. Simply speaking, lipid deposition on the vessel wall causes plaque and is a pathological aging process of the vessel wall. For example, it is like the rust of the inner wall of the water pipe and the thickening of the pipe wall. Arterial plaques are not formed at once. Usually, the atherosclerotic plaque of a human carotid artery begins to develop faintly from puberty (about 15 years old), and becomes obvious until about 40 years old. There are only a handful of people with no arteriosclerotic plaque found in the carotid artery. The wall of the blood vessel has three layers, the intima, the media, and the outer membrane. The plaque forms early, and only shows thickening of the intima, which is the surface of the blood vessel that is in direct contact with the blood. To put it simply, just as the skin grows wrinkles with age, the thickening of the intima begins to reflect the aging of the vessel wall, and the lining of the membrane continues to thicken. For an average age of 10 years, the thickness of the medial membrane increases by 0.1 mm. More than 1mm is diagnosed as an intima-media thickening, and thickening to a certain extent may form atherosclerotic plaque.

 

 

Third, what are the hazards of carotid plaque?

The original smooth intima of the blood vessels is very smooth, and suddenly there is a "sludge" in the "river". The flow pattern and direction of the river in the river will change. The main influences are: 1. The instability of the plaque Sex, that is, plaque that is not strong and easy to fall off on the blood vessel wall. Once the plaque falls off, it becomes an embolus in the bloodstream, which reaches the brain and blocks the distal cerebral artery with blood flow, leading to cerebral infarction. 2, vascular lumen stenosis, if the plaque is small, carotid stenosis <50%, patients can have no obvious clinical symptoms. If the carotid artery stenosis exceeds 50%, the patient may have symptoms associated with insufficient blood supply to the brain.

 

Fourth, how to see the carotid ultrasound report?

The ultrasound report is generally divided into three parts: 1. The report generally describes the carotid intima-media thickness (IMT), generally more than 1 mm to diagnose the intima thickening, the size of the plaque, often used "length mm × thickness mm" Said. 2. It will also describe the location, number, shape and echo characteristics of the plaque. If the plaque is severe to a certain extent, it will lead to stenosis. At this time, the report will describe the stenosis, the residual diameter of the stenosis, and the original diameter. , blood flow velocity at the stenosis. 3. Carotid ultrasound report conclusions We generally report bilateral carotid intima thickening and single (multiple) plaque formation, such as carotid artery stenosis, X side carotid stenosis, the degree of stenosis is generally in percentage (% ) indicates that the degree of stenosis is classified into mild (less than 50%), moderate (50-69%), and severe (70-99%).

 

5. Does carotid plaque fall off and cause stroke?

Many people will ask this question, and worry about excessive anxiety. Unstable plaques have the risk of rupture, secondary thrombosis, and thrombus loss leading to stroke. In fact, most carotid plaques are stable plaques and are unlikely to fall off. Experts at home and abroad have found that long-term strict control of various risk factors, such as smoking cessation, blood sugar lowering, blood pressure, blood lipids, and arterial ultrasound monitoring, some patients can also reduce plaque (also known as "reverse"). Therefore, when we diagnose carotid plaque, do not panic, ultrasound doctors can make accurate judgments on plaque stability and arterial stenosis, and provide a basis for accurate treatment of clinical surgery.

 

In short, atherosclerosis is a disease of systemic blood vessels. Carotid ultrasound is only a window, reflecting to some extent the degree of arteriosclerosis. The purpose of screening for cervical vascular ultrasound is to identify a high-risk group of people with a systemic stroke. Once plaque is found, the nature of the plaque is assessed. Large medical doctors are not ill, regardless of stenosis, plaque, and attention to control risk factors, the most important of which include lifestyle risk factors and disease risk factors. Carotid ultrasound found that plaque is uncomfortable and excessively anxious. It is completely unnecessary. If carotid ultrasound is not a problem, everything will be fine. It is even wrong to continue unhealthy lifestyles (such as continuing to smoke and continue to exercise). Therefore, do well in advance to develop good habits, such as increased exercise, reasonable diet, weight loss, smoking cessation, no alcohol abuse, blood pressure control, blood sugar, blood lipids, etc.