[2] It is most often used to diagnose carotid artery stenosis, a form of atherosclerosis, and has the capability to assess plaque morphology and characteristics.

Advances in imaging have allowed for risk stratification including degree of stenosis and how vulnerable the atherosclerotic plaque is to rupture.

[2] During carotid duplex evaluation, the 2D B-mode structural image is superimposed with the doppler flow data, which provides a more realistic anatomical assessment.

B-mode is used identify stenotic lesions and to assess the echogenicity of plaques—strong correlation has been established between sonographic and histopathologic features of plaques.

[1] Besides, other features such as intima-media thickness, surface of the plaque and presence of ulceration are also useful in predicting the possibility of stroke or heart attack in the future.

ICA has low resistive pattern (difference between the blood velocities during heart systole and diastole) when compared to ECA.

[3] Contrast-enhanced ultrasound (CEUS) is valuable because the contrast does not diffuse into surrounding tissues, and therefore all signals are intravascular.

[2] Contraindications to the ultrasound contrast include allergy, heart failure, acute coronary syndrome, endocarditis, ventricular arrhythmia, and unstable respiration.