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Doctor insights on: Which Result Is More Reliable Doppler Or Cta Of Neck Carotid For A Patient Of Tia Symptoms

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For patients with CAD, if carotid ultrasound imaging came out normal, do you need cta of the neck. Can this wait. When do you actually needs it.?

For patients with CAD, if carotid ultrasound imaging came out normal, do you need cta of the neck. Can this wait. When do you actually needs it.?

Not usually: If the carotid duplex ultrasound imaging is normal and the patient is a symptomatic I would not suggest cta.
Sometimes the calcium defeats the ultrasound and cta or angio may be necessary. ...Read more

Dr. James Wilentz
155 Doctors shared insights

Transient Ischemic Attack (Mini Stroke) (Definition)

A condition where a blood vessel in the brain is temporarily blocked by a blood clot, causing neurologic symptoms, such as weakness in an arm or leg, or sensory changes. The symptoms are similar to a stroke, but are temporary, disappearing within minutes after the clot breaks apart. ...Read more


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What to do if I had a cta of neck and wondering what the impression means?

What to do if I had a cta of neck and wondering what the impression means?

Contact ordering doc: If you don't understand what the impression of your CTA means, you should contact the doctor that ordered that exam be done for you. You may also contact the Radiologist that interpreted the exam. ...Read more

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How can a dopplar test and mra on a carotid artery show different results dopplar-no blockage mra-severe stenosis happened to my husband now cta next?

How can a dopplar test and mra on a carotid artery show different results dopplar-no blockage mra-severe stenosis happened to my husband now cta next?

Doppler: Is technician dependent and mra can sometime overestimate the degree of stenosis. Cta is the test of choice for carotids. Angiogram remains the gold standard but not commonly done any more since it is more invasive and does carry a small risk of stroke. ...Read more

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Normal Carotid Doppler Studies.1- Right ICA encircling the Internal carotic artery. 2- Complex mass in the right thyroid lobe. History Neck cancer.

Normal Carotid Doppler Studies.1- Right ICA encircling the Internal carotic artery. 2- Complex mass in the right thyroid lobe. History Neck cancer.

Thyroid ultrasound: You need a neck ultrasound to fully evaluate the thyroid. Possibly will need a fine needle biopsy if the complex mass is big enough. The first thing is to fully evaluate the neck with an ultrasound. ...Read more

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Did carotid ultrasound imaging and came out normal. Possible CABG short term. Is cta of the neck needed, how much radiation it adds or risk.?

Did carotid ultrasound imaging and came out normal. Possible CABG short term. Is cta of the neck needed, how much radiation it adds or risk.?

Shouldn't: If u/s clear, should be good to go. If they still want a cta, is fair to ask & get rationale, as aren't free--$/dye/rad--it's a reasonable question. If do have to get it, not a huge radiation load as mostly soft tissues. ...Read more

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A patient of 65 years has bilateral pedal edema. Everythng is being evaluated. Thyroid n kidney tests n doppler is normal. Tell me further wht to do?

A patient of 65 years has bilateral pedal edema. Everythng is being evaluated. Thyroid n kidney tests n doppler is normal. Tell me further wht to do?

Many possibilities: Some of the most common causes for pedal edema include: excess salt intake, varicose veins, prolonged sitting, certain medications (calcium channel blockers, pioglitazone, steroids). You did not mention if a heart evaluation has been done, as heart failure is also a common cause. Avoiding salt is very important to help decrease pedal edema. ...Read more

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Thyroid nodules -should patient know? Us features microcalcifications, shape, hypoechogenicity, type III color power doppler do doctors look carefully?

Thyroid nodules -should patient know? Us features microcalcifications, shape, hypoechogenicity, type III color power doppler do doctors look carefully?

Thyroid nodules: Many people have thyroid nodules. Most are benign. There are many features that a radiologist will look for in thyroid nodules to help determine if further evaluation is needed. The most important features are calcification, taller than wide nodules and irregular microlobulations. If need be a fna or core biopsy can be preformed. ...Read more

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Husband had eye stroke had dopplar & mta dopplar showed blood flow no blockage mta showed severe stenosis carotid artery how does this happen next cta?

Carotid stenosis: If severe, greater than 60%, then you should consider a potential entarterectomy or even stunting to prevent additional stroke events. Some evidence to suggest also, potential benefit of anti-platelet medication such as Aggrenox and a statin. Discuss with a stroke neurologist, and a vascular surgeon. ...Read more

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Can tias over time be caused by temporary or partial occlusion of vertebral or carotid arteries and cause foci or lesions?

Can tias over time be caused by temporary or partial occlusion of vertebral or carotid arteries and cause foci or lesions?

Yes: Tia's are short-lived, about 20-30- minutes and usually fully reverse. If not, it is a stroke with tissue damage, and then can be seen on an mri. The event heralds risk, and preventative treatment with an antiplatelet drug should be started. An embolism from say the heart or aorta, may need anti-coagulation. The greatest future risk of TIA is a stroke within one year. ...Read more

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Should someone in his late 80s (with history of tias) have his carotids checked?

Should someone in his late 80s (with history of tias) have his carotids checked?

Absolutely: Someone who is having tias should most definitely have their carotids checked since the carotid arteries are the number one source for embolic strokes. In "symptomatic" patients, such as someone who is having tias, a carotid blockage of 50% or more warrants intervention. ...Read more

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Is it possible that a shunt of the carotid artery produce a positive test result on transcranial doppler?

Is it possible that a shunt of the carotid artery produce a positive test result on transcranial doppler?

If you: Are talking about an arterial venous fistula, then this lesion has abnormal flow detected on carotid and transcranial doppler. ...Read more

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Can an upright MRI find an issue with neck that conventional MRI cannot if patient complains symptoms like panic/anx only occur while standing?

Can an upright MRI find an issue with neck that conventional MRI cannot if patient complains symptoms like panic/anx only occur while standing?

No: Assuming you can find an upright mri, this would not give any more information. Quite the contrary, any non-conventional mri, be it extremity (sitting), or open, produces lower quality images than conventional mri. ...Read more

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Could poor posture/computer work cause miserable aching down both sides of neck at the same time? Strong carotid pulse, no chest pain/neuro symptoms.

Could poor posture/computer work cause miserable aching down both sides of neck at the same time? Strong carotid pulse, no chest pain/neuro symptoms.

Yes: There are two muscle groups running on either side of your spine in the back of your neck that cause both neckache and tension headaches. Massage therapist now, better posture next time. :). ...Read more

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Carotid artery disease, different results from duplex ultrasound vs. Ct angiogram (cta), is that possible?

Carotid artery disease, different results from duplex ultrasound vs. Ct angiogram (cta), is that possible?

Results: Because these are two different imaging modalities, it is possible to get divergent results. Generally however these two studies show congruent data. ...Read more

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Carotid artery disease, what to believe, if different results from duplex ultrasound vs. Ct angiogram (cta)?

Carotid artery disease, what to believe, if different results from duplex ultrasound vs. Ct angiogram (cta)?

CTA better: Although cta is more accurate but it also depends on image quality done by radiology. If there is two conflicting studies of the carotid artery, then you should get the gold standard conventional arteriography if clinically indicated. ...Read more

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I am a symptomatic euthyroid hashimoto's patient. What can I do to lessen symptoms since I do not receive thyroid medicine?

I am a symptomatic euthyroid hashimoto's patient. What can I do to lessen symptoms since I do not receive thyroid medicine?

Treatment: The TSH goal in a confirmed hashimoto's patient is different than a normal person. In hashimoto's we would like TSH to be < 2. If your TSH is higher than this, it is ok to start treatment even though technically it is still in the normal range. Discuss this with your doctor. ...Read more

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Endo has got my thyroid level to just within the correct range, what else can be done for a hashimotos patient that still has all the symptoms?

Endo has got my thyroid level to just within the correct range, what else can be done for a hashimotos patient that still has all the symptoms?

Desiccated thyroid: Check out http://jcem. Endojournals. Org/content/98/5/1982.Abstract in which a recent study suggested that some patients feel better on dessicated thyroid extract. This may be heresy so point out study to your doc. It doesn't mean you have to stay on it forever but it might be worth a try. One other issue: which end of normal did you just reach? Many feel better when TSH 1-2 (not 4.49). ...Read more

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Endo has got my thyroid level to just within the correct range, what else can be done for a hashimotos patient that still has all the symptoms?

Maybe increase T4: If the TSH level is in the normal range but closer to the upper limit (2.5 - 5), it may be reasonable to increase the dose of T4 to bring down TSH level to the lower half of the normal range (0.4 - 2.5). This is based on the observation that most young volunteers with normal thyroid function have TSH level < 2.5. However, it is not certain that increasing the dose will improve symptoms. Good luck! ...Read more

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Would you be able to see if a patient had throat cancer if doing an upper endoscopy? How sure can you be you don't have throat cancer when result neg?

Would you be able to see if a patient had throat cancer if doing an upper endoscopy? How sure can you be you don't have throat cancer when result neg?

Perhaps: An upper endoscopy is a fiberoptic procedure typically administered by a gastroenterologist. The patient is usually sedated and lying down. The goal of this procedure is to look at the upper GI tract. A better exam to evaluate for laryngeal or pharyngeal cancer is a flexible fiberoptic laryngosocpy. This is performed by an head and neck surgeon. It is a smaller scope passed through the nose. ...Read more

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What are some thyroid symptoms that patients often have?

What are some thyroid symptoms that patients often have?

Hypo and hyper: Activity. Hypothyroidism presents as cold intolerance, constipation, dry skin, weakness and weight gain. Hyperthyroidism presents with anxiety, heat intolerance, rapid pulse rate, diarrhea, weight loss despite good appetite, warm flushed moist skin. ...Read more

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Vl carotid bilat post TIA found:l internal carotid stenosis 50-79% by velocity. F/u with neck contrast mra, shows nothing normal study! How can it be?

Vl carotid bilat post TIA found:l internal carotid stenosis 50-79% by velocity. F/u with neck contrast mra, shows nothing normal study! How can it be?

Velocity accurate: Most likely accurate ultrasound.

Repeat at 6 months.
Unlikely a dissection with resolution- but possible. Or increased flow after tia? Would be unusual.
Mra has value but some limitations of stenosis measurements. ...Read more

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What's more accurate, a color carotid doppler ultrasound or a contrast coratid mra?

What's more accurate, a color carotid doppler ultrasound or a contrast coratid mra?

Both good: Ultrasound is a good screening test. Can give idea about plaque make up. Mra shows flow but can overestimate amount of stenosis. Cta best if ultrasound not normal. ...Read more

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What is more accurate, a color carotid doppler ultrasound or a contrast carotid mra?

What is more accurate, a color carotid doppler ultrasound or a contrast carotid mra?

Carotid: A carotid doppler is a good screening procedure. A mra or cta of the carotids is more accurate but not the way to screen patients. ...Read more

Cta (Definition)

Computed tomography angiography. Specialized contrast enhanced CT technique that visualizes the blood vessels. Can simulate a traditional angiogram without ...Read more