American Journal of Neuroradiology, Vol 13, Issue 6 1581-1587, Copyright © 1992 by American Society of Neuroradiology
ARTICLES |
Color-flow Doppler sonography in the identification of ulcerative plaques in patients with high-grade carotid artery stenosis
H Furst, WH Hartl, I Jansen, D Liepsch, L Lauterjung and FW Schildberg
Department of Surgery, Klinikum Grosshadern, Ludwig-Maximilian University School of Medicine, Munich, Germany.
PURPOSE: To assess the ability of color-flow Doppler sonography (CFDS) to detect plaque ulcerations in patients who had high-grade to thread- like carotid artery stenosis and who underwent carotid endarterectomy. METHODS: CFDS is a noninvasive diagnostic technique that allows, in addition to spatial visualization of blood flow, the identification of abnormal blood flow patterns such as vortex formation. There is evidence that pathologic anatomic changes in the vascular wall (such as ulcerations) may result in characteristic hemodynamic alterations. Therefore, solely hemodynamic criteria (detection of vortices) were used to diagnose ulceration. The results of preoperative examinations were compared to the intraoperative findings in 89 patients in a prospective and blinded way. RESULTS: CFDS proved highly sensitive (95.3%), specific (93.5%), and accurate (94.0%) for demonstrating ulcerative plaques. CONCLUSION: CFDS may be of significant advantage for examining plaque morphology in patients who have high-grade internal carotid artery stenosis, and in whom accurate, noninvasive diagnosis of plaque ulceration was previously difficult, if not impossible.
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