獨協医科大学における頸動脈エコー検査とその記録法

Abstract

We aimed to discuss the current reporting systems for carotid ultrasonography used in Japan, with a view to achieving further improvement. Our hospital performs carotid artery ultrasonography mainly in patients with cerebrovascular disease. The common, internal and external carotid arteries, and vertebral artery are routinely examined. We measure plaque score, properties of plaque, maximum intima-media thickness and end-diastolic ratio, in addition to stenosis ratio (i.e., diameter ratio, NASCET, and ECST methods), area of stenosis, and peak systolic velocity at the point of stenosis. Transcranial sonography is employed to measure middle cerebral artery and basilar artery blood flow velocities, and to evaluate substantia nigra hyperechogenicity for Parkinsonian disorders. Sonographic examinations of the temporal artery for temporal arteritis, lower extremity, and aortic arch are performed as needed. We use two types of reports: hand-written and electronic. Electronic reports are useful and linked to the electronic medical record; however, they are also time-consuming. Therefore, we mainly use handwritten reports, which are suitable for describing and delineating the status of carotid plaque in detail. We discuss herein the merits and deficits of the types of carotid ultrasonography used in our and other facilities in order to develop the most appropriate methods for reporting.