Key result
The peak systolic velocity ratio (PSVICA/ICA) showed the highest correlation with computed tomography angiography for evaluating internal carotid artery stenosis severity (r = 0.576, p < 0.001).
Why the study?
Accurate assessment of carotid stenosis severity is important for proper patient management, prompting evaluation of four duplex sonography measurements against computed tomography angiography and the impact of plaque morphology.
Does the PSVICA/ICA ratio measured by duplex sonography improve correlation with CTA for evaluating internal carotid artery stenosis severity compared to other sonographic parameters?
Observational (n=143)
Yes
Does the PSVICA/ICA ratio measured by duplex sonography improve correlation with CTA for evaluating internal carotid artery stenosis severity compared to other sonographic parameters?
The PSVICA/ICA ratio demonstrates the highest correlation with CTA for evaluating internal carotid artery stenosis across most plaque morphologies, supporting its inclusion in routine duplex sonography assessment.
Answers are grounded in this paper and cite their sources.
PSVICA/ICA ratio may merit inclusion in DUS protocols; leaves open whether it improves CTA correlation over other parameters.
Background Accurate assessment of carotid stenosis severity is important for proper patient management. The present study aimed to compare the evaluation of carotid stenosis severity using four duplex sonography (DUS) measurements, including peak systolic velocity (PSV), PSV ratio in stenosis and distal to stenosis (PSVICA/ICA ratio), end-diastolic velocity (EDV), and B-mode, with computed tomography angiography (CTA), and to evaluate the impact of plaque morphology on correlation between DUS and CTA. Methods Consecutive patients with carotid stenosis of ≥40% examined using DUS and CTA were included. Plaque morphology was also determined using magnetic resonance imaging. Spearman’s correlation and Kendall’s rank correlation were used to evaluate the results. Results A total of 143 cases of internal carotid artery stenosis of ≥40% based on DUS were analyzed. The PSVICA/ICA ratio showed the highest correlation [Spearman’s correlation r = 0.576) with CTA, followed by PSV (r = 0.526), B-mode measurement (r = 0.482), and EDV (r = 0.441; p < 0.001 in all cases]. The worst correlation was found for PSV when the plaque was calcified (r = 0.238), whereas EDV showed a higher correlation (r = 0.523). Correlations of B-mode measurement were superior for plaques with smooth surface (r = 0.677), while the PSVICA/ICA ratio showed the highest correlation in stenoses with irregular (r = 0.373) or ulcerated (r = 0.382) surfaces, as well as lipid (r = 0.406), fibrous (r = 0.461), and mixed (r = 0.403; p < 0.01 in all cases) plaques. Nevertheless, differences between the mentioned correlations were not statistically significant (p > 0.05 in all cases). Conclusion PSV, PSVICA/ICA ratio, EDV, and B-mode measurements showed comparable correlations with CTA in evaluation of carotid artery stenosis based on their correlation with CTA results. Heavy calcifications and plaque surface irregularity or ulceration negatively influenced the measurement accuracy.
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Pakizer et al. (2023) conducted an observational in Internal carotid artery stenosis (n=143). Duplex sonography (PSVICA/ICA ratio) vs. Computed tomography angiography (CTA) was evaluated on Correlation between PSVICA/ICA ratio and CTA for evaluating carotid stenosis severity (r = 0.576, p=<0.001). The peak systolic velocity ratio (PSVICA/ICA) showed the highest correlation with computed tomography angiography for evaluating internal carotid artery stenosis severity (r = 0.576, p < 0.001).
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