High-grade stenosis of the internal carotid artery assessed by color and power Doppler imaging

Schmidt, Peter Koerver; Sliwka, Ulrich; Simon, Stefan-Georg; Noth, Johannes

doi:10.1002/(sici)1097-0096(199802)26:2<85::aid-jcu6>3.0.co;2-e

Cited by 12 publications

(5 citation statements)

References 20 publications

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“…In the poststenotic segment, low flow volumes can be detected only with difficulty [7,17]. In addition, the angle-dependency of CCDS does not only influence the velocity measurement, but also the simultaneous establishment of the prestenotic, intrastenotic and poststenotic flow in the longitudinal scan, in particular for tortuous vessels [23][24][25]. Difficult conditions, such as a carotid bifurcation with relatively cranial location, a kinking of the vessel or distinct calcification in the vessel wall, can complicate the situation and lead to wrong diagnoses [4,7,11].…”

Section: Discussionmentioning

confidence: 99%

Diagnostics and characterisation of preocclusive stenoses and occlusions of the internal carotid artery with B-flow

et al. 2006

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The purpose was to evaluate whether B-flow can improve the ultrasonographic diagnosis of preocclusive stenosis and occlusion of the internal carotid artery (ICA) compared with colour-coded Doppler and power Doppler. Ninety patients with occlusions or preocclusive stenoses of the ICA suspected by Doppler sonography were examined with B-flow in comparison with colour-coded Doppler sonography (CCDS), power Doppler (PD) and intra-arterial digital subtraction angiography (DSA). Intrastenotic flow detection and lengths of stenoses were the main criteria. Ulcerated plaques found by surgery in 42/90 patients were compared by ultrasonography (US). Diagnosis of ICA occlusion with CCDS, PD and B-flow was correct in all 42 cases. A preocclusive ICA stenosis in DSA was detected correctly in all 48/48 cases (100%) for B-flow, in 44/48 (92%) for PD and in 39/48 (81%) for CCDS. Surgical findings showed in 17/42 cases ulcerated plaques; 15/17 (89%) of these cases were detected with B-flow, 12/17 (71%) with PD, 10/17 (59%) with CCDS, and 8/17 (47%) with DSA. With B-flow the extent of stenosis was appraised more precisely than with PD and CCDS (P<0.0001). In conclusion, B-flow is a reliable method for preocclusive stenosis of the ICA with less intrastenotic flow artefacts. B-flow facilitates the characterization of plaque morphologies.

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Section: Discussionmentioning

confidence: 99%

Diagnostics and characterisation of preocclusive stenoses and occlusions of the internal carotid artery with B-flow

et al. 2006

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“…Similar to stenosis assessment by pulsed-wave Doppler spectral analysis, the CD scanning mode processes information of frequency or phase shift for visualization of blood flow. It may therefore not be sur- Because of the lack of aliasing phenomenon and because of improved blood-tissue discrimination by special filter systems, PD mode scanning provides clearer displays of the intrastenotic lumen 14,19 and is believed to be more accurate for ICA stenosis assessment 13,14,19 compared with CD scanning. In this study, PD mode scanning did not show the assumed superiority over CD mode scanning and also demonstrated a greater weakness in evaluating very tight stenoses (>80%) by use of ECST criteria.…”

Section: Discussionmentioning

confidence: 99%

Comparison of color-flow Doppler scanning, power Doppler scanning, and frequency shift for assessment of carotid artery stenosis

Müller

Ciccotti

Reiche

et al. 2001

Journal of Vascular Surgery

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“… 1–4 Power or amplitude‐coded Doppler has been shown to be more accurate than colour Doppler imaging in assessing critical carotid stenoses and defining plaque contours and morphology. 5,6 The angle independence and increased sensitivity to slow flow of power Doppler is obviously advantageous in the assessment of the critically stenotic ICA; colour Doppler is limited by noise artefacts and aliasing in this situation.…”

Section: Discussionmentioning

confidence: 99%

Value of a contrast agent in equivocal carotid ultrasound studies: Pictorial essay

Holden

Hope

Osborne

et al. 2000

Australasian Radiology

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The aim of the present study was to assess the use of an echo-enhancing agent (Levovist; Schering AG) in equivocal carotid bifurcation ultrasound studies and compare the information obtained with digital subtraction angiography (DSA). Contrast-enhanced carotid ultrasound studies were performed on 30 carotid bifurcations in 28 patients. The standard carotid ultrasound examinations were considered equivocal for two reasons: apparent acute internal carotid artery occlusions (n = 10), and possibly patent but critically stenosed internal carotid arteries with the residual flow lumen being incompletely visualized (n = 20). All patients underwent subsequent carotid digital subtraction angiography. All patients with apparent acute carotid occlusions (n = 10) were correctly characterized on contrast-enhanced ultrasound when compared with DSA. The majority were complete occlusions (n = 8) although in two cases there were critical carotid stenoses requiring surgical endarterectomy. In the 'incompletely visualized lumen' group (n = 20), the majority (n = 16) were correctly characterized on contrast enhanced ultrasound: 13 cases of critically stenotic but patent internal carotid arteries, two cases without a haemodynamically significant stenosis and one case of a carotid occlusion with patent vasa vasorum. One of the critical carotid stenoses was prospectively reported as occluded on the 'gold standard' angiography. In three cases the flow lumen was still incompletely visualized due to calcified plaque despite an echo-enhancing agent; angiography revealed no significant stenosis in all cases. There was one false negative for internal carotid occlusion. This occurred early in the series and could be considered to be a technical error. Importantly, there were no false positives for carotid occlusion. Contrast-enhanced carotid ultrasound significantly improves diagnostic confidence in equivocal carotid ultrasound studies. In appropriate clinical settings this may reduce the need for subsequent carotid angiography.

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High-grade stenosis of the internal carotid artery assessed by color and power Doppler imaging

Cited by 12 publications

References 20 publications

Diagnostics and characterisation of preocclusive stenoses and occlusions of the internal carotid artery with B-flow

Diagnostics and characterisation of preocclusive stenoses and occlusions of the internal carotid artery with B-flow

Comparison of color-flow Doppler scanning, power Doppler scanning, and frequency shift for assessment of carotid artery stenosis

Value of a contrast agent in equivocal carotid ultrasound studies: Pictorial essay

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