Ultrsound Questions- newbie here

I asked my pain management specialist dr to order a bilateral jugular ultrasound from the imaging center.
The imaging center is confused and im getting a carotid ultrasound that is going to take 1.5 hours and cost $2000. TUES morn.
Then they wanted to give me a bilateral arm vein scan which I told them to cancel cause its not right. They said I need a CPT code to price anything else but everyone is so confused. Does anyone have any helpful info on the exact name or number for the test in the US?

For context. I have Eagle’s dx and surgery scheduled but surgeon is making me pick which side to start with

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Kaycee -

I’d cancel the Carotid US because I don’t think you need something that extensive. I don’t
If you don’t have symptoms of vascular ES there’s no need for you to get additional scanning. If you think you do, have you determined for sure the symptoms are IJV compression as opposed to ICA (internal carotid artery) compression?

The type of ultrasound you’d need to check for IJV compression is done close to where your neck meets your head i.e. up by your C-1 vertebra. If the styloid is growing at an angle that brings it close to the C-1 vertebra, the IJV can get trapped/squashed between them. This often happens when the head is in a position(s) other than neutral (looking at the ceiling while lying on your back) thus the need to have the scan done “dynamically” i.e. with your head turned left/right, up/down, & on the diagonals. What a knowledgeable US tech looks for is variation in blood flow rate above C-1 & below it. That is an indicator that there is vascular compression. Even with an experienced tech, compression isn’t always found even if it’s there. That’s why we recommend a CTA or MRA/MRV as better diagnostic tools. A CTA (generic term whether looking at veins or arteries) can be done dynamically whereas an MRA/MRV cannot.

An Interventional Radiologist or ENT who is familiar with ES is the best type of doctor to see for getting the types of scans I mentioned above.

I have symptoms but can’t tell which side is coming from necessarily…my appt is scheduled for tomorrow… cta and mrv s are done with contrast? I got an mri last month and it didn’t go down far enough to see my c1 vert is squashing against brain stem impinging fluid they saw… this would be which side to do the eagles surgery. I also have a ct which shows to styloids but no vascularature

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How did you make out? I gave the same question because my lab only could only do a neck MRA not V. So I also need to have ny dr visualize the jugular vein in the neck. It’s questionable as to whether I have a vascular case as the MRA/MRV of the head was normal. MRA of neck was also normal. He says he can’t see the IJV in the neck (only carotid).
I thought it was a soft tissue neck ultrasound needed, is that not the right name? I don’t think you ask for a specific side. Also, my dr said the only reason a Doppler can be problematic is because they have to get very high up.

i skipped it. My doctor said she would call and straighten it out and she didn’t. just going to go on blind faith this is just the right surgery

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I might as well. Sending good wishes.

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