Ultrasonic characteristics of carotid webs

Purpose This study aimed to retrospectively analyze the ultrasonographic images of 46 cases of carotid web (CW) and summarize their manifestations to reduce the rate of misdiagnosis. Methods For the analysis of ultrasonic manifestations, 46 patients with a confirmed diagnosis of CW by digital subtraction angiography (DSA) and CT angiography (CTA) in our hospital from January 2015 to October 2020 were collected. The location and the morphology of CW, the presence of a plaque at the base and thrombus at the surrounding of the CW, and whether they resulted in arteriostenosis were discussed. Results The average age of 46 patients was 43.23 ± 4.89 years old and there were 18 males and 28 females. Fifteen patients were admitted with cerebral infarction. The CW was located at the initial segment of the internal carotid artery in 22 cases, the bifurcation of the carotid artery in 20 cases, and the common carotid artery in 4 cases. CW in 5 patients was longer than half of the artery diameter, two patients with “cliff-like” arteriostenosis, 29 patients with plaques, and 16 patients with thrombi. The CW grew in the direction of the blood flow without obvious fluttering. The CW has a higher display rate on the ultrasound longitudinal section than the transverse section. Conclusion We identified some typical ultrasound characteristics of CW. Recognizing them will improve diagnostic accuracy of CW by ultrasonography.