Previous investigators have demonstrated that B-mode ultrasonography can provide high resolution images of the carotid arteries. When combined with Doppler flow measurements, quantitative estimates of luminal narrowing may also be obtained. B-mode imaging is limited, however, in its ability to provide a composite view of the vessel wall, lumen and plaque. Spatial relations between structures visualized in individual frames must be inferred from repeated transducer passes over the designated site, or repeated review of recorded images, followed by a “mind's eye” reconstruction. Three-dimensional (3-D) reconstruction of serially recorded cross-sectional images from current B-mode systems represents a possible solution to this limited spatial display that preserves detail regarding vessel wall pathology. Accordingly, computer-based automated 3-D reconstruction was used to generate a tangible format with which to assess and compare serially and transcutaneously recorded 2-dimensional (2-D) B-mode images of the carotid arteries. One or more timed sweep recordings of the 2-D B-mode examination were obtained from 5 patients for 3-D reconstruction. In all cases, satisfactory 3-D reconstruction was accomplished in three 3-D formats: cylindrical, sagittal and lumen cast. Sagittal 3-D reconstruction provided information regarding pathologic alterations within the arterial wall. Experience with the cylindrical mode suggests that this 3-D format, particularly when the reconstructed vascular segment is hemisected, is optimally suited for those cases in which direct inspection of luminal topography is of special interest. The lumen cast display, used with a recently validated edgedetection algorithm, may enhance the use of B-mode ultrasound for assessment of luminal crosssectional area. This preliminary experience suggests that 3-D reconstruction may supplement in a meaningful way noninvasively recorded conventional B-mode images of the extracranial vasculature.

The development, in 1985, of phased array scanning in a linear format1 established the potential for acquiring high quality color flow Doppler (CFD) maps of the vasculature in the lower extremities. Subsequently, however, little information has been published2,3 describing examination of the peripheral arteries by CFD, whether in linear, sector or anular format. Accordingly, the present study was undertaken to evaluate the utility of CFD in combination with 2-dimensional ultrasound (2DU) for the assessment of peripheral vascular disease.