Continuous-wave Doppler and real-time ultrasound demonstrated 95% agreement with angiography for diagnosing significant carotid stenosis and 100% accuracy for normal or occluded vessels.
Observational (n=100)
Do continuous-wave Doppler and real-time ultrasound accurately diagnose carotid artery stenosis and ulceration compared to angiography in patients with asymptomatic carotid bruit or TIA?
Continuous-wave Doppler and real-time ultrasound are highly accurate non-invasive methods for diagnosing significant carotid stenosis and may be more reliable than angiography for detecting plaque ulceration.
One hundred patients with asymptomatic carotid bruit or transient ischemic attack (TIA) underwent continuous-wave Doppler (CWD) and real time ultrasound (RTU) testing of their cervical carotid arteries. After ultrasonic studies, 51 patients also underwent bilateral carotid angiography. There was 95% agreement between CWD and angiography for the diagnosis of a significant (greater than 50%) stenosis. The RTU diagnosis of a normal or occluded vessel was correct in 100% of cases. Seven plaques appreciated on RTU may not have been large enough for detection by angiography. In this small series, ulceration confirmed pathologically was more reliably predicted by RTU than by cerebral angiography. Significant ipsilateral carotid plaques occurred more often in patients with amaurosis fugax than in patients with hemispheric TIAs. Ipsilateral plaque ulceration occurred in 50% of symptomatic carotid bruits, but in only 10% of asymptomatic carotid bruits. Plasma concentrations of total cholesterol were significantly higher in TIA patients with carotid stenosis than in controls.
Lo et al. (Wed,) conducted a observational in Asymptomatic carotid bruit or transient ischemic attack (n=100). Continuous-wave Doppler and real-time ultrasound vs. Bilateral carotid angiography was evaluated on Agreement between CWD and angiography for the diagnosis of a significant (>50%) stenosis. Continuous-wave Doppler and real-time ultrasound demonstrated 95% agreement with angiography for diagnosing significant carotid stenosis and 100% accuracy for normal or occluded vessels.