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Doppler US Velocity Measurements

Department of Radiology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121 e-mail: ebluth@ochsner.org

Editor:

With regard to the article recently published in Radiology (1), I found observations that "internal carotid artery [ICA] peak systolic velocities decrease with advancing age and increase with increasing pulse pressure" interesting. This is a topic to which I have devoted a considerable amount of attention.

I would like to point out that an appreciation of the effect of blood pressure on ICA velocities caused us (2) to recommend the use of ratios of ICA velocity to common carotid artery systolic and diastolic velocities as a means to grade stenosis and eliminate variability caused by, among other things, blood pressure. This has been controversial to some, and, although the authors did not discuss it, findings from their article support the greater use of these ratios. In their article, and in several others included in their discussion and reference sections, the value of these ICA to common carotid artery ratios is not mentioned as a means to more accurately grade stenosis and correct for blood pressure variability. I believe their observations emphasize the value of relying more on these ratios than on the peak systolic velocity alone and therefore validate their use.

REFERENCES

1. Spencer EB, Sheafor DH, Hertzberg BS, et al. Nonstenotic internal carotid arteries: effects of age and blood pressure at the time of scanning on Doppler US velocity measurements. Radiology 2001; 220:174-178.[Abstract/Free Full Text]
2. Bluth EI, Stavros AT, Marich KW, Wetzner SM, Aufrichtig D, Baker JD. Carotid duplex sonography: a multicenter recommendation for standardized imaging and Doppler criteria. RadioGraphics 1988; 8:487-506.[Abstract]

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