(Stroke. 1996;27:95-100.)
© 1996 American Heart Association, Inc.
Articles |
Cerebrovascular Disease Assessed by Color-Flow and Power Doppler Ultrasonography
Comparison With Digital Subtraction Angiography in Internal Carotid Artery Stenosis
From the Departments of Neurology and Neuroradiology (G.K.), Ernst Moritz Arndt University Greifswald (Germany).
Correspondence to Christof Kessler, MD, Department of Neurology, Ernst Moritz Arndt University of Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany.
Background and Purpose An understanding of carotid atherosclerosis is important to further our knowledge regarding the etiology of cerebral ischemia, and therefore it is necessary to accurately visualize carotid stenosis. The purpose of the present study was to compare different imaging techniques to determine their advantages and disadvantages in the diagnosis and quantification of middle- and high-grade internal carotid artery stenosis. In particular, we were interested in evaluating the effectiveness of the new ultrasound technique power Doppler.
Methods Fifty-four patients with greater than 50% extracranial internal carotid artery stenosis, as determined by continuous-wave Doppler, were recruited prospectively to serve as subjects. All subjects were examined with color-flow Doppler, power Doppler, and digital subtraction angiography to enable visualization of carotid stenosis and plaque surface morphology.
Results Thirty-four middle-grade stenoses (50% to 69%), 32 high-grade stenoses (70% to 99%), and 7 complete occlusions of the internal carotid artery were diagnosed with the use of digital subtraction angiography. Power Doppler visualized stenosis significantly more frequently and accurately than color-flow Doppler. Color-flow Doppler tended to overestimate and underestimate in patients with both middle- and high-grade stenosis. Power Doppler was superior to both color-flow Doppler and angiography with regard to differentiation of plaque surface morphology.
Conclusions This study demonstrates that power Doppler is an important, noninvasive imaging technique that has several advantages over color-flow Doppler in diagnosing carotid artery stenosis and visualizing plaque surface. Power Doppler, used in concert with other ultrasound techniques, should enable a more accurate detection and treatment of cerebrovascular disease.
Key Words: angiography • carotid artery disease • carotid stenosis • Doppler • ultrasonics
This article has been cited by other articles:
 |
|
 |
|
  M. Reiter, R. Horvat, S. Puchner, W. Rinner, P. Polterauer, J. Lammer, E. Minar, and R.A Bucek Plaque Imaging of the Internal Carotid Artery--Correlation of B-Flow Imaging with Histopathology AJNR Am. J. Neuroradiol., January 1, 2007; 28(1): 122 - 126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.O. Oktar, C. Yucel, D. Karaosmanoglu, K. Akkan, H. Ozdemir, N. Tokgoz, and T. Tali Blood-Flow Volume Quantification in Internal Carotid and Vertebral Arteries: Comparison of 3 Different Ultrasound Techniques with Phase-Contrast MR Imaging. AJNR Am. J. Neuroradiol., February 1, 2006; 27(2): 363 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. G. Grant, C. B. Benson, G. L. Moneta, A. V. Alexandrov, J. D. Baker, E. I. Bluth, B. A. Carroll, M. Eliasziw, J. Gocke, B. S. Hertzberg, et al. Carotid Artery Stenosis: Gray-Scale and Doppler US Diagnosis--Society of Radiologists in Ultrasound Consensus Conference Radiology, November 1, 2003; 229(2): 340 - 346. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Schulte-Altedorneburg, D. W. Droste, S. Felszeghy, L. Csiba, V. Popa, K. Hegedus, J. Kollar, L. Modis, and E. B. Ringelstein Detection of Carotid Artery Stenosis by In Vivo Duplex Ultrasound: Correlation With Planimetric Measurements of the Corresponding Postmortem Specimens Stroke, October 1, 2002; 33(10): 2402 - 2407. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Umemura and K. Yamada B-Mode Flow Imaging of the Carotid Artery Stroke, September 1, 2001; 32(9): 2055 - 2057. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Norris and P. M. Rothwell Noninvasive carotid imaging to select patients for endarterectomy: Is it really safer than conventional angiography? Neurology, April 24, 2001; 56(8): 990 - 991. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Melissano, R. Castellano, R. Zucca, and R. Chiesa Results of Carotid Endarterectomy Performed with Preoperative Duplex Ultrasound Assessment Alone Vascular and Endovascular Surgery, March 1, 2001; 35(2): 95 - 101. [Abstract] [PDF]
|
|
|
|
|
|
M. Koga, K. Kimura, K. Minematsu, and T. Yamaguchi Diagnosis of Internal Carotid Artery Stenosis Greater than 70% with Power Doppler Duplex Sonography AJNR Am. J. Neuroradiol., February 1, 2001; 22(2): 413 - 417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Claudon, D. Winninger, S. Briançon, and P. Pesque Power Doppler US: Evaluation of the Morphology of Stenoses with a Flow Phantom Radiology, January 1, 2001; 218(1): 109 - 117. [Abstract] [Full Text]
|
|
|
|
|
|
P. M. Rothwell, S. T. Pendlebury, J. Wardlaw, and C. P. Warlow Critical Appraisal of the Design and Reporting of Studies of Imaging and Measurement of Carotid Stenosis Stroke, June 1, 2000; 31(6): 1444 - 1450. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. S. Lin, D. T. Milburn, and S. Briggs Power Doppler: How It Works, Its Clinical Benefits, and Recent Technologic Advances Journal of Diagnostic Medical Sonography, July 1, 1998; 14(4): 151 - 161. [Abstract] [PDF]
|
|
|
|
|
|
W. Steinke, S. Ries, N. Artemis, A. Schwartz, and M. Hennerici Power Doppler Imaging of Carotid Artery Stenosis : Comparison With Color Doppler Flow Imaging and Angiography Stroke, October 1, 1997; 28(10): 1981 - 1987. [Abstract] [Full Text]
|
|
|
|
|
|
N. Suwanwela, U. Can, K. L. Furie, J. F. Southern, N. R. Macdonald, C. S. Ogilvy, C. J. Hansen, F. S. Buonanno, W. M. Abbott, W. J. Koroshetz, et al. Carotid Doppler Ultrasound Criteria for Internal Carotid Artery Stenosis Based on Residual Lumen Diameter Calculated From En Bloc Carotid Endarterectomy Specimens Stroke, November 1, 1996; 27(11): 1965 - 1969. [Abstract] [Full Text]
|
|
|
|
|
|
S. M. El-Saden, E. G. Grant, G. M. Hathout, P. T. Zimmerman, S. N. Cohen, and J. D. Baker Imaging of the Internal Carotid Artery: The Dilemma of Total versus Near Total Occlusion Radiology, November 1, 2001; 221(2): 301 - 308. [Abstract] [Full Text] [PDF]
|
|