Color-flow Doppler and conventional duplex scanning of the carotid bifurcation: prospective, double-blind, correlative study

Hallam, MJ; Reid, J. D. S.; Cooperberg, PL

doi:10.2214/ajr.152.5.1101

Cited by 44 publications

(9 citation statements)

References 5 publications

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“…Standard duplex ultrasound is said to be able to quantify vessel stenosis with a high sensitivity (91-94 %) and specificity (85-99 %) [9]. Colour-flow Doppler alone is said to be equally accurate in assessing stenotic lesions [10]. A problem identified with duplex ultrasound is that highgrade stenoses may be misinterpreted as occlusions [11].…”

Section: Discussionmentioning

confidence: 99%

The role of duplex sonography and angiography in the investigation of carotid artery disease

et al. 1997

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Some patients with symptomatic carotid stenoses of greater than 70 % benefit from carotid endarterectomy. This study was designed to compare the accuracy of duplex ultrasound with angiography in assessing the degree of carotid stenosis in 73 patients with symptoms of recent carotid territory ischaemia. Ultrasound was found to be most accurate in the group of patients with normal vessels or mild stenoses (0-29 %) when there was 90 % concordance between ultrasound and angiography. Ultrasound was found to be least accurate in the group of patients with severe stenoses (70-99 %) in whom it was more likely to underestimate than to overestimate the degree of stenosis. Only one patient said to have < 30 % stenosis on ultrasonography had a > 70 % stenosis on IADSA. Our results indicate that patients with normal arteries or mild disease shown by ultrasound have a very small chance of having surgically amenable lesions in the neck. Ultrasound is reliable as an exclusory screening test. However, all other stenoses should also be investigated by catheter angiography if surgery is considered. Taking angiography as the reference, only 52 % of patients with severe stenoses, which might be taken as an indication for surgery, were correctly identified on ultrasonography. Ultrasound alone is a poor technique for identifying patients for surgery and a combination of ultrasound screening with angiography for > 30 % stenoses detected by ultrasound is recommended.

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Section: Discussionmentioning

confidence: 99%

The role of duplex sonography and angiography in the investigation of carotid artery disease

et al. 1997

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“…Poststenotic areas may have a mosaic color Doppler pattern due to multiple velocities and flow reversal in a boundary separation zone. [21][22][23] In the face of a nearly occluded lumen, a narrow hairline string of color through the plaque called the "string sign" may be seen. Power Doppler sonography may aid in the visualization of the residual lumen because of its higher sensitivity to lower velocities.…”

Section: Color Doppler Imagingmentioning

confidence: 99%

Diagnosing Carotid Stenosis by Doppler Sonography

Gaitini

Soudack

2005

Journal of Ultrasound in Medicine

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Objective. The goal of this review article is to present the state of the art in the clinical applications and technical performance and interpretation of carotid sonographic examinations. Methods. Relevant publications regarding color and duplex Doppler sonography (CDDS) of the carotid arteries extracted from a computerized database (MEDLINE) and from references cited in these articles not appearing on the Internet were reviewed. Results. The ability to quickly and efficiently identify stenosis in the carotid artery is an important goal for clinicians and vascular surgeons. Identification of potentially treatable carotid stenosis enables selection of appropriate candidates for endarterectomy or stent implantation. Advances in performance and interpretation of carotid sonographic studies over the last 20 years have been driven by technological improvements in gray scale and CDDS examinations and have made carotid sonography an important means to reach this goal. On the basis of CDDS, intimamedia thickness measurements and plaque location and characterization on gray scale imaging, flow disturbance and areas of stenosis on color Doppler sonography, and flow velocities on spectral Doppler sonography are obtained. The degree of the diameter of a stenosis of the internal carotid artery is the main parameter used for therapeutic approaches. Advantages and limitations of the method are included. Conclusions. Carotid sonography is a unique imaging method for the investigation of carotid abnormalities. Noninvasive, accurate, and cost-effective, it provides morphologic and functional information. It is increasingly becoming the first and often the sole imaging study before endarterectomy, whereas costly and invasive procedures are reserved for special cases.

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“…Higher degrees of luminal narrowing produce the typical flow disturbances, such as intrastenotic velocity increase, poststenotic flow separation and reversal, poststenotic disturbed flow, and turbulence ( Fig. 2) [48,49,50]. Diagnosis of stenosis by color Doppler ultrasound is generally based on a recognizable reduction of the perfused lumen and the flow disturbances described.…”

Section: Pathological Findingsmentioning

confidence: 99%

Ultrasound examination of carotid and vertebral arteries

Landwehr¹,

Schulte

Voshage³

2001

Eur Radiol

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Ultrasound is the most widespread diagnostic procedure in obstructive disease of the arteries supplying the brain. The combined non-invasive information on morphology and function makes duplex ultrasound the procedure of choice in screening and follow-up of carotid artery disease. This review deals with all relevant aspects of color duplex ultrasound of the carotids and the vertebral arteries. After a short introduction into the clinical background, the paper focuses on aspects of examination technique. In the main part of the review the relevant ultrasound findings in carotid artery disease are discussed. The different methods for grading stenoses of the internal carotid artery are explained in detail. Other relevant pathologies, such as vertebral artery disease, dissection and aneurysms, are briefly mentioned. The clinical value of ultrasound in the work-up of carotid and vertebral artery disease is briefly discussed in comparison with other imaging procedures.

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Color-flow Doppler and conventional duplex scanning of the carotid bifurcation: prospective, double-blind, correlative study

Abstract: Color

Cited by 44 publications

References 5 publications

The role of duplex sonography and angiography in the investigation of carotid artery disease

The role of duplex sonography and angiography in the investigation of carotid artery disease

Diagnosing Carotid Stenosis by Doppler Sonography

Ultrasound examination of carotid and vertebral arteries

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