EURORAD ESR

Case 15184

Internal carotid artery intraluminal thrombus: demonstration with MDCTA and follow-up with US

Author(s)
Vasileios Rafailidis, Ioannis Chryssogonidis, Irini Nikolaou, Anna Kalogera-Fountzila

Department of Radiology, AHEPA University General Hospital of Thessaloniki, Greece
Email:billraf@hotmail.com
 
Patient
male, 66 year(s)
 
 
  • Figure 1
    First MDCTA examination of the carotid system
     

    Sagittal reformatted MDCTA image showing the right internal carotid artery atherosclerotic plaque causing near-occlusion. Note is made of a short round filling defect cranially to the plaque which can be attributed to...

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Arteriosclerosis;

    Thick maximum intensity projection (MIP) sagittal image better visualizing the pre-occlusive lesion and the down-stream filling defect.

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Arteriosclerosis;

    Axial MDCTA image showing the filling defect being completely surrounded by contrast medium, in keeping with the “donut sign” (arrowhead).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Arteriosclerosis;

    Second contiguous axial MDCTA image showing the filling defect being completely surrounded by contrast medium, in keeping with the “donut sign” (arrowhead).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Arteriosclerosis;

    Volume Rendering (VR) technique image showing the near-occlusive plaque and the intraluminal filling defect cranially to the lesion (arrowhead).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Arteriosclerosis;
     
     
  • Figure 2
    Follow-up carotid US
     

    Pulse-wave Doppler image showing the increase in peak systolic velocity at the point of maximum stenosis, within a severely stenotic lumen.

     
    Area of Interest: Vascular; Imaging Technique: Ultrasound-Spectral Doppler; Procedure: Diagnostic procedure; Special Focus: Arteriosclerosis;

    Colour Doppler image showing a predominantly echogenic plaque with smooth surface and severe luminal stenosis. The internal carotid artery lumen down-stream is normally filled with blood flow signals, showing no...

     
    Area of Interest: Vascular; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Arteriosclerosis;

    Power Doppler image confirming the down-stream internal carotid artery lumen patency.

     
    Area of Interest: Vascular; Imaging Technique: Ultrasound-Power Doppler; Procedure: Diagnostic procedure; Special Focus: Arteriosclerosis;
     
     
Sagittal reformatted MDCTA image showing the right internal carotid artery atherosclerotic plaque causing near-occlusion. Note is made of a short round filling defect cranially to the plaque which can be attributed to intraluminal carotid thrombus.
 
Thick maximum intensity projection (MIP) sagittal image better visualizing the pre-occlusive lesion and the down-stream filling defect.
 
Axial MDCTA image showing the filling defect being completely surrounded by contrast medium, in keeping with the “donut sign” (arrowhead).
 
Second contiguous axial MDCTA image showing the filling defect being completely surrounded by contrast medium, in keeping with the “donut sign” (arrowhead).
 
Volume Rendering (VR) technique image showing the near-occlusive plaque and the intraluminal filling defect cranially to the lesion (arrowhead).
 
Pulse-wave Doppler image showing the increase in peak systolic velocity at the point of maximum stenosis, within a severely stenotic lumen.
 
Colour Doppler image showing a predominantly echogenic plaque with smooth surface and severe luminal stenosis. The internal carotid artery lumen down-stream is normally filled with blood flow signals, showing no filling defect.
 
Power Doppler image confirming the down-stream internal carotid artery lumen patency.
 
 
 
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