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February 1, 1992Australasian Radiology

Comparison of Duplex Ultrasound with Angiography in Assessment of Carotid Bifurcation Disease

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Why the study?

Does duplex ultrasound accurately assess the degree of stenosis and plaque characteristics compared to angiography in patients with carotid bifurcation disease?

Population

39 patients with atherosclerotic disease of the carotid bifurcation, prior to prospective endarterectomy…

Comparison

Duplex ultrasound vs Angiography (gold standard)

Design

Cross-sectional

Authors

NYNoel YoungWestmead HospitalYSYoi Sun SooRoyal Prince Alfred HospitalPFPaula FischerSanta Casa Hospital

Discussion

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Implication

Ultrasound sensitivity varies by segment and ulceration; leaves open its standalone diagnostic role versus angiography in carotid disease.

Key Points

  • To evaluate the diagnostic accuracy of duplex ultrasound compared to invasive angiography in assessing carotid bifurcation atherosclerosis prior to endarterectomy.
  • Evaluated 39 patients scheduled for prospective carotid endarterectomy who underwent both duplex ultrasound and angiography within one month of each other.
  • Characterized carotid plaques by sonography based on surface contour (smooth or irregular) and internal composition (homogeneous or heterogeneous).
  • Duplex ultrasound demonstrated a 92% sensitivity relative to angiography for assessing stenosis severity in the internal carotid artery.
  • Ultrasound sensitivity was lower in adjacent vessels, reaching 63% for the common carotid arteries and 65% for the external carotid arteries.
  • Ultrasound exhibited low diagnostic accuracy in detecting plaque ulceration when compared directly against angiography.

Structured PICO

Does duplex ultrasound accurately assess the degree of stenosis and plaque characteristics compared to angiography in patients with carotid bifurcation disease?

P
Population
39 patients with atherosclerotic disease of the carotid bifurcation, prior to prospective endarterectomy surgery
I
Intervention
Duplex ultrasound
C
Comparator
Angiography (gold standard)
O
Outcome
Sensitivity in assessing the degree of internal carotid stenosissurrogate

Duplex ultrasound is highly sensitive for assessing internal carotid stenosis but less accurate for evaluating common or external carotid arteries and plaque ulceration compared to angiography.

Cite This Study

Young et al. (1992) studied this question.

synapsesocial.com/papers/6a7146b65d37378ac1de6dffhttps://doi.org/10.1111/j.1440-1673.1992.tb03076.x
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Duplex carotid sonography: criteria for stenosis, accuracy, and pitfalls.1985 · 122 citations
  2. 2Color-flow Doppler and conventional duplex scanning of the carotid bifurcation: prospective, double-blind, correlative study1989 · 48 citations
  3. 3Internal carotid artery stenosis: accuracy and reproducibility of color-Doppler-assisted duplex imaging.1989 · 148 citations
  4. 4Diagnostic criteria for carotid duplex sonography1988 · 133 citations