Journal of Ultrasound in Medicine, Vol 17, Issue 11 683-686, Copyright © 1998 by American Institute of Ultrasound in Medicine
Mirror image artifacts of color Doppler images causing misinterpretation in carotid artery stenoses
C. Arning
Department of Neurology, Allgemeines Krankenhaus Barmbek, Hamburg, Germany.
A knowledge of mirror image artifacts in color-coded duplex sonography is
important as they can lead to diagnostic problems in the morphologic
evaluation of stenoses and plaques. Mirror image artifacts were detectable
in stenosed vessels when strongly reflecting plaques on the wall of the
vessel distant from the transducer head were insonated obliquely. The
artifacts were revealed in regions that were hypoechoic or anechoic on
B-mode scans. Depending on the angle of insonation and the surface
structure of the plaque, the mirror image artifact could be linked with the
vessel lumen and thus imitate ulcerations or branches. The artifact
appeared in both the longitudinal and the transverse projections and also
occurred in the power Doppler and in pulsed Doppler sonographic modes.
Mirror image artifacts with linkages to the vessel lumen that could result
in a misinterpretation were seen in 2.5% of the stenosed vessels.
