CCI - Cardiovascular Credentialing International Cerebrovascular Duplex Examinations Questions and Answers

Question 1

A sonographer performs a carotid duplex exam and obtains the following measurements in the left internal carotid artery (ICA): Peak Systolic Velocity (PSV) = 255 cm/s, End-Diastolic Velocity (EDV) = 110 cm/s, and an ICA/CCA PSV ratio of 4.5.
Based on the Society of Radiologists in Ultrasound (SRU) consensus criteria, what is the estimated degree of stenosis?

Accepted Answer

≥70% stenosis to near occlusion

Answer

<50% stenosis

Answer

50-69% stenosis

Answer

Total occlusion

Question 2

Which of the following findings is most definitive for identifying the External Carotid Artery (ECA) as distinct from the Internal Carotid Artery (ICA)?

Accepted Answer

Visualization of cervical branches

Answer

A higher resistance spectral waveform

Answer

Smaller diameter compared to the ICA

Answer

Anteromedial location relative to the ICA

Question 3

A duplex ultrasound of the vertebral arteries reveals sustained retrograde (reversed) flow in the left vertebral artery. This finding is a classic sign of which condition?

Accepted Answer

Occlusion or high-grade stenosis of the proximal left subclavian artery

Answer

High-grade stenosis of the left internal carotid artery

Answer

Occlusion of the basilar artery

Answer

Stenosis of the right brachiocephalic artery

Question 4

During a carotid evaluation, the sonographer observes a low-velocity, delayed systolic upstroke, and rounded systolic peak in the left Common Carotid Artery (CCA). This waveform morphology, known as 'tardus parvus,' suggests a significant stenosis in which location?

Accepted Answer

Left Subclavian or Brachiocephalic Artery

Answer

Left Internal Carotid Artery (ICA)

Answer

Left Vertebral Artery

Answer

Right Common Carotid Artery (CCA)

Question 5

A sonographer identifies atherosclerotic plaque in the carotid bifurcation that appears brightly echogenic and produces a strong posterior acoustic shadow, obscuring the vessel wall behind it. How is this type of plaque best characterized?

Accepted Answer

Ulcerated

Answer

Soft

Answer

Homogeneous

Answer

Calcified

Question 6

A patient with stroke-like symptoms undergoes a carotid duplex scan. In the proximal ICA, the sonographer notes a very narrow, trickle-flow channel on color Doppler. Spectral Doppler reveals a markedly reduced peak systolic velocity of 40 cm/s and an end-diastolic velocity of 15 cm/s. These findings are most indicative of:

Accepted Answer

Near occlusion

Answer

50-69% stenosis

Answer

A normal, small vessel

Answer

Total occlusion