Agreed about the Halo sign. Using the latest hockey stick transducers have greatly boosted the visualization of that notoriously tricky area. Similar to struggling with superficial varices using the 7 linear then putting on the 15mhz matrix and going wow! 

The Halo likely arose from when everything appeared black. Vessels should appear just hypoechoic when the media is inflamed. 

The IM measurements are a nice idea (like ABI's and carotid velocities) but most positives are a pretty easy subjective call on our part. I do like the U of W idea for compressing and measuring the complete non compressible IM walls and dividing by 2 to give an idea about what 1 wall would measure.

As for colour, I have had good success on the GE LE9 using colour B-flow for sensitivity and so as to not overwrite the vessel wall. On the LE10 I have to use the MVI microvascular imaging for the same. Other systems probably have similar settings.

cheers,

Harvey

On Sat, 5 Mar 2022 13:50:18 -0500, Andy Bebry <[log in to unmask]> wrote:

>No arguments here!!  Any input and thought provoking information is
>appreciated. Andy Bebry
>
>On Sat, Mar 5, 2022 at 11:58 AM Larry Needleman <[log in to unmask]> wrote:
>
>> I think the "halo" is a bit misleading.
>>
>> Recent articles have used measurements along with the halo. Another sign
>> is difficulty compressing due to the edema in the wall.
>>
>> The halo is usually shown with color Doppler pictures. When the color is
>> off the wall looks gray to me. With the color on less signal to create the
>> gray scale and I think more contrasty gray scale so the wall looks darker.
>>
>> Do people get really dark walls with gray scale.
>>
>> BTW we are finding it easier to measure with the much higher frequency
>> probes, 16-22 Mhz.
>>
>> Thoughts?
>>
>> Larry Needleman
>>
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