You can take the following steps to prepare for your appointment:

• Call the day before the exam to confirm the time and location of the exam.
• Wear a comfortable shirt with no collar or an open collar.
• Don't wear a necklace or dangling earrings.

Unless your health care provider or the radiology lab provides special instructions, you shouldn't need to make any other preparations.

How it works

A technician called a sonographer conducts the test with a small, hand-held device called a transducer. The transducer emits sound waves and records the echo as the waves bounce off tissues, organs and blood cells.

A computer translates the echoed sound waves into a live-action image on a monitor. The ultrasound technician may use a Doppler ultrasound, which shows blood flowing through the arteries. In a Doppler ultrasound, the rate of blood flow is translated into a graph.

There have been vast technological advances in carotid ultrasounds, improving the quality and resolution of the images.

A carotid ultrasound usually takes about 30 minutes.

During the procedure

You'll likely lie on your back during the ultrasound. The ultrasound technician may position your head to better access the side of your neck.

The ultrasound technician will apply a warm gel to your skin above the site of each carotid artery. The gel helps transmit the ultrasound waves back and forth. The technician then gently presses the transducer against the side of your neck.

You shouldn't feel any discomfort during the procedure. If you do, tell the ultrasound technician.

A doctor who specializes in imaging tests, called a radiologist, will review your test results, then prepare a report for the health care provider who ordered the test. This may be your health care provider, a doctor trained in heart and blood vessel conditions, called a cardiologist, or a doctor trained in brain and nervous system conditions, called a neurologist.

The radiologist also may discuss the results of the test with you immediately after the procedure.

The health care provider who ordered the test will explain to you what the carotid ultrasound revealed and what that means for you.

If the test shows that you're at risk of a stroke, your health care provider may recommend the following therapies depending on the severity of the blockage in your arteries:

• Eat a healthy diet, including fruits, vegetables, and whole-grain breads and cereals, and limit saturated fat.
• Exercise regularly.
• Keep a healthy weight.
• Eat a heart-healthy diet such as the Mediterranean diet
• Don't smoke, and avoid secondhand smoke.
• Take medications to lower blood cholesterol and blood pressure.
• Take medications to prevent blood clots.
• Have a surgical procedure to remove carotid artery plaques. This procedure is called carotid endarterectomy.
• Have a surgical procedure to open and support your carotid arteries. This procedure is called carotid angioplasty and stenting.

If your health care provider ordered the carotid ultrasound as a follow-up to a surgical procedure, your provider can explain whether the treatment is working and whether you'll need additional treatment or follow-up exams.

Additional tests

If your results are unclear, you may have additional imaging tests, including:

• A computerized tomography angiogram (CTA) scan. A CTA scan uses a series of X-rays to produce detailed images of the blood vessels in the body. A dye may be injected into a vein to make the carotid arteries easier to see on the scan.
• Magnetic resonance imaging (MRI). An MRI uses a magnetic field and radio waves to produce detailed images of soft tissues in the body. A magnetic resonance angiography (MRA) scan also may be performed to get a better look at blood vessels.
• Contrast-enhanced ultrasound (CEUS). An intravenous contrast agent helps find early hardening of the arteries and evaluate future vascular disease.
• 3D ultrasound. This test improves the visualization of blood vessels and helps in evaluating plaque progression, but it may underestimate narrowing of the carotid artery.