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(Stroke. 2002;33:2402.)
© 2002 American Heart Association, Inc.

Original Contributions

Detection of Carotid Artery Stenosis by In Vivo Duplex Ultrasound

Correlation With Planimetric Measurements of the Corresponding Postmortem Specimens

Gernot Schulte-Altedorneburg, MD; Dirk W. Droste, MD; Szabolcs Felszeghy, DDS, PhD; László Csiba, MD, PhD; Vasile Popa, MD; Katalin Hegedüs, MD, PhD; József Kollár, MD, PhD; László Módis, MD, PhD E. Bernd Ringelstein, MD

From the Departments of Neurology (G.S-A., L.C., V.P., K.H.), Anatomy, Histology and Embryology (S.F., L.M.), and Radiology (J.K.), University of Debrecen, Medical and Health Science Centre, Faculty of Medicine, Debrecen, Hungary, and Department of Neurology, University of Münster, Münster, Germany (G.S-A., E.B.R.).

Correspondence to Gernot Schulte-Altedorneburg, MD, Department of Radiology, Klinikum Augsburg, Stenglinstr 2, D-86156 Augsburg, Germany. E-mail Gernot.SAD{at}gmx.de

Background and Purpose— The correct detection and quantification of carotid artery disease are of decisive impact on patient prognosis and adequate treatment. In this study, we evaluated the ability of ultrasonography to detect and to grade carotid artery stenosis through a comparison of the in vivo ultrasound findings with the planimetric analysis of the corresponding postmortem specimens.

Methods— Shortly before their death, 59 critically ill neurological patients (mean age, 70 years) were prospectively examined by extracranial and intracranial Doppler sonography and color-coded duplex ultrasound. Carotid stenosis was classified by hemodynamic and morphological ultrasound criteria. Carotid specimens were removed in toto during autopsy. Under standardized conditions, specimens were redistended, sectioned, and histologically processed. Computerized planimetric measurements of the arteries were carried out and compared with the ultrasound findings. Correlation of the ultrasound and postmortem planimetric findings was available in 93 carotid bifurcations.

Results— Through both techniques, 46 carotid arteries were found to be normal. Steno-occlusive carotid lesions ranged from 8.5% to 100% lumen reduction. Overall, r=0.96 and adjusted R²=0.90. For the steno-occlusive carotid lesions, r=0.91.

Conclusions— Extracranial and intracranial Doppler and color-coded duplex ultrasound permits reliable detection and quantification of carotid artery stenoses and occlusions even under difficult examination conditions in critically ill patients.

Key Words: carotid arteries • diagnosis • pathology • ultrasonography

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