High-frame rate vector flow imaging of the carotid bifurcation

Carotid artery atherosclerotic disease is still a significant cause of cerebrovascular morbidity and mortality. A new angle-independent technique, measuring and visualizing blood flow velocities in all directions, called vector flow imaging (VFI) is becoming available from several vendors. VFI can provide more intuitive and quantitative imaging of vortex formation, which is not clearly distinguishable in the color Doppler image. VFI, as quantitative method assessing disturbed flow patterns of the carotid bifurcation, has the potential to allow better understanding of the diagnostic value of complex flow and to enhance risk stratification. This pictorial review article will show which new information VFI adds for the knowledge of hemodynamics in comparison to the conventional ultrasound techniques. TEACHING POINTS • VFI is an angle-independent technique measuring flow velocities in all directions. • This kind of VFI is based on a plane wave multidirectional excitation technique. • VFI allows quantitative assessment of carotid streamlines progression and visualizes vorticity. • VFI does not allow a precise comprehension of streamlines' 3D shape. • VFI allows a better understanding of carotid artery complex flows.