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Comparison of Carotid Doppler Ultrasound to Other Angiographic Modalities in the Measurement of Carotid Artery Stenosis
Author(s) -
Boyko Matthew,
Kalashyan Hayrapet,
Becher Harald,
Romanchuk Helen,
Saqqur Maher,
Rempel Jeremy L.,
Derksen Carol,
Shuaib Ashfaq,
Khan Khurshid
Publication year - 2018
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12532
Subject(s) - medicine , radiology , stenosis , digital subtraction angiography , magnetic resonance angiography , kappa , stroke (engine) , ultrasound , angiography , doppler ultrasound , carotid arteries , magnetic resonance imaging , computed tomography angiography , nuclear medicine , mechanical engineering , linguistics , philosophy , engineering
BACKGROUND AND PURPOSE The purpose of this study was to compare Doppler ultrasound (DUS) to other angiographic modalities: computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA). METHODS All DUS studies performed at Stroke Prevention Clinic (SPC) from 2011 to 2013 and referred for further angiographic modalities were included. Patients were excluded if the corresponding angiographic modality was not performed within 6 months of DUS. Patients were also excluded if they underwent interventions before DUS or between the time of DUS and the corresponding angiographic modality. The degree of stenosis was classified as mild (<50%), moderate (50‐69%), severe (70‐99%), or occlusion (100%). RESULTS In total, 245 patients were identified. Nine patients were excluded (3.7%). Overall 472 Doppler studies of single ICAs from 236 patients were included in our analysis. Age was 65 ± 13 years and 136 patients were males (57.6%). There was an excellent agreement between DUS and CTA (kappa = .9 [ P < .001], n = 274), good agreement with MRA (kappa = .8 [ P < .001], n = 242), and excellent agreement with DSA (kappa = .92 [ P < .001], n = 18). There was excellent agreement between CTA and MRA (kappa = .87, n = 46). CONCLUSION Doppler ultrasound performed in a dedicated SPC by an experienced sonographer and reviewed by a certified stroke neurologist serves as a reliable initial screening tool in determining carotid artery stenosis.