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December 1, 1989Radiology

Internal carotid artery stenosis: accuracy and reproducibility of color-Doppler-assisted duplex imaging.

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Why the study?

Does color-Doppler-assisted duplex sonography accurately and rapidly detect significant internal carotid artery stenosis compared to angiography and nonassisted duplex ultrasound?

Population

60 carotid bifurcations evaluated for internal carotid artery stenosis

Comparison

Color-Doppler-assisted duplex sonography vs Angiography and nonassisted duplex ultrasound

Design

Cross-sectional

Authors

JPJoseph F. PolakBoston UniversityGDG R DobkinBrigham and Women's HospitalDOD H O'LearyTufts University

Discussion

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Overview

Supports color-Doppler-assisted duplex for carotid stenosis screening; leaves open prospective validation against angiography.

Key Points

  • To prospectively determine the accuracy, speed, and reproducibility of color-Doppler-assisted duplex sonography for diagnosing internal carotid artery stenosis.
  • Assessed 60 carotid bifurcations using color-Doppler-assisted duplex sonography, sampling spectral analysis at the site of maximal color shift.
  • Validated diagnostic findings against conventional angiography as the reference standard.
  • Measured procedural time compared to nonassisted duplex ultrasound and calculated interobserver agreement correlation coefficients.
  • A measured peak systolic velocity exceeding 1.25 m/sec demonstrated 87% diagnostic accuracy for detecting internal carotid artery stenosis greater than 50%.
  • Identification of maximal velocity was 40% faster using color-Doppler assistance compared with nonassisted duplex ultrasound.
  • Interobserver agreement yielded a correlation coefficient of 0.90 overall, improving to 0.97 when excluding bifurcations with acoustic shadowing greater than 1 cm (7% of cases).

Structured PICO

Does color-Doppler-assisted duplex sonography accurately and rapidly detect significant internal carotid artery stenosis compared to angiography and nonassisted duplex ultrasound?

P
Population
60 carotid bifurcations evaluated for internal carotid artery stenosis
I
Intervention
Color-Doppler-assisted duplex sonography
C
Comparator
Angiography (for accuracy) and nonassisted duplex ultrasound (for rapidity)
O
Outcome
Accuracy in detecting significant internal carotid artery stenosis (>50%)surrogate

Color-Doppler-assisted duplex sonography is an accurate, rapid, and reproducible non-invasive method for detecting significant internal carotid artery stenosis.

Limitations

  • Extensive acoustic shadowing (>1 cm) in 7% of bifurcations reduced interobserver agreement

Cite This Study

Polak et al. (1989) studied this question.

synapsesocial.com/papers/6a88f6ab3fe85f489c1fee13https://doi.org/10.1148/radiology.173.3.2682776
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Carotid artery disease assessed by color Doppler flow imaging: correlation with standard Doppler sonography and angiography.1990 · 104 citations
  2. 2Carotid Artery Disease Assessed by Color Doppler Flow Imaging: Correlation with Standard Doppler Sonography and Angiography1990 · 66 citations
  3. 3Color-flow Doppler and conventional duplex scanning of the carotid bifurcation: prospective, double-blind, correlative study1989 · 48 citations
  4. 4Detection of internal carotid artery stenosis: comparison of MR angiography, color Doppler sonography, and arteriography.1992 · 150 citations
  5. 5CT angiography and Color Doppler ultrasonography features and sensitivity in detection of carotid arteries diseases2013