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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:1294-1299, August 2003
© 2003 American Society of Neuroradiology

HEAD AND NECK

Three-Dimensional Color Doppler Sonography in Carotid Artery Stenosis

Robert A. Bucek^a, Markus Reiter^b, Albert Dirisamer^a, Markus Haumer^b, Angelika Fritz^b, Erich Minar^b and Johannes Lammer^a

^a University Clinic for Radiology, Department of Angiography and Interventional Radiology, Vienna General Hospital, Vienna, Austria
^b University Clinic for Internal Medicine II, Department of Angiology, Vienna General Hospital, Vienna, Austria

Address reprint requests to Robert A Bucek, M.D., Clinic for Internal Medicine II, Department of Angiology, General Hospital, Währinger Gürtel 18–20, A-1090 Vienna, Austria

BACKGROUND AND PURPOSE: Color Doppler sonography (CDS) suffers from such disadvantages as high interobserver variability and problems with data presentation and storage. We therefore performed a prospective trial to assess the role of three-dimensional CDS (3D-CDS) in the evaluation of internal carotid artery stenosis (ICAS).

METHODS: We included 32 consecutive patients with sonographically verified ICAS (30–99%) and 16 asymptomatic volunteers. All underwent CDS and 3D-CDS, and 23 patients also underwent intraarterial angiography. The sensitivity, specificity, positive predictive value, and negative predictive value for the detection of high-grade ICAS were analyzed by three blinded readers, who also graded the percentage of ICAS.

RESULTS: CDS revealed 14 patients with mild to moderate ICAS and 18 patients with high-grade ICAS. Mean sensitivity of 3D-CDS was 81.5%, mean specificity was 98.9%, mean positive predictive value was 97.9%, and mean negative predictive value was 89.9%. 3D-CDS correlated significantly with CDS (mean r = 0.85; P < .001) and angiography (mean r = 0.57; P = .01).

CONCLUSION: 3D-CDS findings correlate with those obtained by CDS and angiography; 3D-CDS also offers excellent interobserver correlation, positive predictive value, and specificity, approaching 100% for the detection of high-grade ICAS.

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