Diagnosis of carotid artery disease - comparison between directional Doppler, Duplex scanner and angiography

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Abstract
Examinations with directional Doppler (DD) with 10 MHz transducer, and pulsed Doppler in combination with 2-dimensional sector scanner with 3 MHz transducer (Duplex) were carried out on 100 vessels in 51 patients with transitory ischemic attacks (TIA) and minor stroke within the territory of the internal carotid artery before angiography. The question at tissue was to evaluate the accuracy of both methods in discriminating between occlusion and stenosis. A correct diagnosis was made by DD in 92 vessels out of 100 and by Duplex in 98 out of 100. All 9 occlusions were correctly diagnosed by Duplex, but only 5 of them by DD, while the 4 remaining vessels were considered as stenosis > 50%. Out of 15 stenoses > 50%, 14 were correctly detected by Duplex and 11 by DD. One patient with tortuous vessel without stenosis was classified as > 50% stenosis by Duplex, and 1 vessel with 1 mm lumen was called occlusion by Duplex and DD. The Duplex scanner offers an increased possibility to differ high-grade stenosis and occlusion of the carotid arteries as compared with earlier non-invasive techniques.