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Discrepancies in recommended criteria for grading of carotid stenosis with ultrasound
Author(s) -
Jogestrand Tomas,
FredénLindqvist Johan,
Lindqvist Madeleine,
Lundgren Susanne,
Tillman AnnSofie,
Zachrisson Helene
Publication year - 2016
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/cpf.12236
Subject(s) - medicine , stenosis , ultrasound , grading (engineering) , radiology , confusion , angiography , internal carotid artery , carotid arteries , cardiology , psychology , civil engineering , psychoanalysis , engineering
Summary The accuracy of duplex ultrasound for grading of internal carotid artery stenosis has been widely tested and shown to be high. However, different methods for measurement of the degree of carotid stenosis with the golden standard conventional angiography have been used in the different studies. This, together with other factors, has led to some confusion regarding the relation between the ultrasonographically measured flow velocity and the angiographically measured degree of stenosis. The ultrasound criteria that are used in S weden (and in G ermany) differ in an important way from the criteria recommended in N orth A merica and the U nited K ingdom for the same degree of angiographic stenoses. Possible reasons for the discrepancies are discussed in this article. The authors recommend absolute agreement locally whether ECST or NASCET criteria shall be used in the communication between radiologists, clinical physiologists, vascular surgeons, neurologists and other physicians involved in patient management decisions. Angle‐dependent ultrasound criteria should be used and flow velocity measurements with ultrasound should be combined with assessment of plaque burden on 2 D picture.