The accuracy of duplex scanning in 69 comparisons with biplanar angiography in the detection of early carotid disease has been assessed. The various criteria reported for the categorisation of less than 50% disease have been critically analysed. As part of the study, 50 internal carotid arteries of 25 young, presumed normal medical students of mean age 20 years have been examined. The results suggest that duplex scanning has the ability to grade less than 50% carotid disease into normal, 1-24% and 25-49% stenosis categories. The most sensitive indicator of early disease is obtained from the real-time B-scan. The waveform changes of the maximum frequency envelope were more sensitive than spectral broadening except where full spectral broadening was present. For confident assessment, the real-time B-scan and pulsed Doppler must always be used in conjunction.

Adult↗

PubMedDate not supplied

The validation of duplex scanning and continuous wave Doppler imaging: a comparison with conventional angiography.

Colour-coded continuous wave (CW) Doppler imaging and duplex scanning have been assessed prospectively in comparison with biplanar angiography for their accuracy in detecting significant arterial disease in the extracranial circulation. Of 96 comparisons with biplanar angiography, the sensitivity of Doppler imaging was 90% and specificity 98% in the detection of greater than 50% internal carotid stenosis and 86 and 100%, respectively, in the diagnosis of internal carotid occlusion. Of 85 comparisons with biplanar angiography, the sensitivity of duplex scanning was 93% and specificity 98% in the detection of greater than 50% internal carotid stenosis and 92 and 100%, respectively, in the diagnosis of internal carotid occlusion. The value of the peak systolic Doppler shift frequency of the internal carotid artery signal has proved to be the most reliable indicator of greater than 50% stenosis and is utilised in conjunction with a periorbital examination. It is concluded that both Doppler imaging and duplex scanning are effective screening techniques for the presence of significant (greater than 50%) internal carotid artery disease.

Adolescent↗

PubMedDate not supplied

Characterisation of carotid artery disease: comparison of duplex scanning with histology.

The ability of duplex scanning to characterise the component tissue of atheromatous lesions of the internal carotid artery and to detect ulceration has been examined in a histological study of 42 carotid endarterectomy specimens. The results suggest that the only component of atheromatous lesions of the internal carotid artery which can be characterised from the B-scan is calcification. The presence of ulceration, intraluminal and intramural thrombus, fibrous intimal thickening and necrosis are not related to the echogenic appearance of internal carotid stenoses and may not be detected reliably. B-mode imaging alone cannot reliably grade greater than 50% internal carotid stenoses, but when this is combined with pulsed Doppler in the technique of duplex scanning, accurate results may be obtained.

Arterial Occlusive Diseases↗