Experiences of duplex ultrasonography of carotid arteries performed by clinicians--correlation to angiography

Abstract

One hundred and eleven carotid vessels in 56 patients were analysed by high-resolution duplex ultrasound. Vessels were graded as normal, 25, 50 or 75% stenotic and 100% occluded and the results were compared with similarly graded biplanar angiograms. There was absolute agreement in 68.5% of the vessels, agreement within one grade of severity of disease in 27.0%, while poor correlation was obtained in 4.5%. The results of ultrasound and angiography were also related to the surgical specimens obtained after thrombendarterectomy of 23 vessels in 20 patients. Good agreement was obtained between the three methods in 20/23 vessels. In one case ultrasound was better than angiography, in another case the reverse was true and in a third case both methods overdiagnosed a plaque. It is concluded that duplex ultrasound will work in the hands of a clinician and is a reliable non-invasive screening method for carotid artery disease leading to a more optimal selection of candidates for angiography.