Radiology, Vol 149, 523-532, Copyright © 1983 by Radiological Society of North America

ARTICLES

Correlation of high-resolution, B-mode and continuous-wave Doppler sonography with arteriography in the diagnosis of carotid stenosis

WJ Zwiebel, CW Austin, JF Sackett and CM Strother

One hundred thirty-one carotid bifurcations in 73 symptomatic patients were prospectively studied with high-resolution, B-mode sonography (HRS) and continuous-wave Doppler ultrasound (CWD). Twenty-three bifurcations were studied because of asymptomatic bruits, 30 for transient ischemic attacks, and 36 for focal or nonfocal symptoms or signs suggesting occlusive disease. The remaining 42 bifurcations were asymptomatic, with symptoms or signs confined to the contralateral bifurcation. Findings in the common, external, and internal carotid arteries (total, 393 vessels) were tabulated separately for plaque severity (HRS), ulceration (HRS), and degree of occlusion (HRS and CWD). HRS correctly estimated plaque severity in 67% of vessels, with 13% overestimated and 20% underestimated. HRS was only 44% sensitive for detection of 81 angiographically demonstrated ulcers. Among 187 occlusive lesions (ranges, less than 50%, greater than or equal to 50%, less than 70%, greater than or equal to 70% decrease in diameter or complete occlusion) HRS correctly estimated luminal narrowing in 62%, CWD in 30%, and HRS plus CWD in 70%. Among greater than 50% occlusive lesions, HRS was correct in 48%, CWD in 59%, and HRS plus CWD in 69%. These results suggest that (a) HRS is not accurate for diagnosis of ulceration, (b) Doppler and B-mode combined are more accurate than separate use of either procedure for evaluation of occlusive lesions, and (c) the level of accuracy in evaluating plaque and stenosis provides a general estimation of severity of disease but does not allow for precise diagnosis.

This article has been cited by other articles:

				G. M. Hathout, J. R. Fink, S. M. El-Saden, and E. G. Grant Sonographic NASCET Index: A New Doppler Parameter for Assessment of Internal Carotid Artery Stenosis AJNR Am. J. Neuroradiol., January 1, 2005; 26(1): 68 - 75. [Abstract] [Full Text] [PDF]

				E. G. Grant, C. B. Benson, G. L. Moneta, A. V. Alexandrov, J. D. Baker, E. I. Bluth, B. A. Carroll, M. Eliasziw, J. Gocke, B. S. Hertzberg, et al. Carotid Artery Stenosis: Gray-Scale and Doppler US Diagnosis--Society of Radiologists in Ultrasound Consensus Conference Radiology, November 1, 2003; 229(2): 340 - 346. [Abstract] [Full Text] [PDF]

				G. M Hathout, M. J. Duh, and S. M. El-Saden Accuracy of Contrast-Enhanced MR Angiography in Predicting Angiographic Stenosis of the Internal Carotid Artery: Linear Regression Analysis AJNR Am. J. Neuroradiol., October 1, 2003; 24(9): 1747 - 1756. [Abstract] [Full Text] [PDF]

				E. G. Grant, A. J. Duerinckx, S. M. El Saden, M. L. Melany, G. M. Hathout, P. T. Zimmerman, A. K. Marumoto, S. N. Cohen, and J. D. Baker Ability to Use Duplex US to Quantify Internal Carotid Arterial Stenoses: Fact or Fiction?1 Radiology, January 1, 2000; 214(1): 247 - 252. [Abstract] [Full Text]

				L. Birincioglu, K. Arda, H. Bardakci, K. Ozberk, M. Bayazlt, T. Cumhur, O. Tasdemir, and K. Bayazit Carotid Disease in Patients Scheduled for Coronary Artery Bypass: Analysis of 678 Patients Angiology, January 1, 1999; 50(1): 9 - 19. [Abstract] [PDF]

				N. Labropoulos, A. Androulakis, R. Allan, A. D. Giannoukas, E. Touloupakis, T. Tegos, A. Al Kutoubi, and A. N. Nicolaides Value of Color Flow Duplex Imaging in Detection of Subtotal and Total Internal Carotid Artery Occlusion Vascular and Endovascular Surgery, November 1, 1997; 31(6): 775 - 779. [Abstract] [PDF]

				R. Kagawa, K. Moritake, T. Shima, and Y. Okada Validity of B-Mode Ultrasonographic Findings in Patients Undergoing Carotid Endarterectomy in Comparison With Angiographic and Clinicopathologic Features Stroke, April 1, 1996; 27(4): 700 - 705. [Abstract] [Full Text]

				E.B. Ringelstein Skepticism Toward Carotid Ultrasonography : A Virtue, an Attitude, or Fanaticism? Stroke, October 1, 1995; 26(10): 1743 - 1746. [Full Text]

				C. R. Gomez Mapping the Cerebral Blood Vessels With High-Field MRI: Technical and Anatomic Review Angiology, May 1, 1989; 40(5): 436 - 442. [Abstract] [PDF]

				U. Senin, L. Parnetti, M. Mercuri, G. Lupattelli, A. Susta, and G. Ciuffetti Evolutionary Trends in Carotid Atherosclerotic Plaques: Results of a Two-Year Follow-up Study Using an Ultrasound Imaging System Angiology, May 1, 1988; 39(5): 429 - 436. [Abstract] [PDF]