CCI Cerebrovascular Duplex Examinations 2

Question 1

Which waveform characteristic is MOST indicative of a high-grade internal carotid artery stenosis (>70%)?

Accepted Answer

Increased peak systolic velocity with spectral broadening

Answer

High-grade ICA stenosis produces markedly elevated PSV with turbulent post-stenotic spectral broadening due to disturbed flow.

Question 2

The ICA/CCA PSV ratio is used to grade ICA stenosis; a ratio greater than what value correlates with ≥70% stenosis by NASCET criteria?

Accepted Answer

4.0

Answer

An ICA/CCA PSV ratio >4.0 is consistent with ≥70% ICA stenosis per the Society of Radiologists in Ultrasound consensus.

Question 3

A patient presents with a right-sided carotid bruit. Duplex shows a focal color aliasing jet in the proximal ICA with PSV of 320 cm/s and EDV of 110 cm/s. What is the most likely stenosis category?

Accepted Answer

≥70% stenosis

Answer

PSV ≥300 cm/s and EDV ≥100 cm/s are consistent with ≥70% ICA stenosis by SRU criteria.

Question 4

When performing vertebral artery duplex examination, which segment is most commonly visualized using duplex ultrasound?

Accepted Answer

V2 (intraforaminal segment)

Answer

The V2 intraforaminal segment between C2 and C6 is the most consistently accessible window for vertebral artery duplex imaging.

Question 5

A patient with subclavian steal syndrome would demonstrate which vertebral artery flow pattern on the affected side during reactive hyperemia of the arm?

Accepted Answer

Bidirectional (to-and-fro) flow converting to full retrograde

Answer

Partial subclavian steal shows bidirectional flow at rest that converts to complete retrograde flow during arm hyperemia as demand increases.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Cerebrovascular Duplex Examinations 2