[Exploration of the cervical arteries within the framework of an angiology service. Our experience using Doppler spectral analysis]

Abstract

Diagnosis and quantification of severity of carotid lesions were assessed by different procedures. Oculoplethysmography was of value only in cases of significant occlusive lesions. Ultrasound methods possessed enhanced sensitivity: Doppler velocimetry, ultrasound imaging and particularly spectral analysis of the Doppler signal. Efficacy of this exploratory method was assessed in a department of angiology, spectral analysis being rated as 5 different grades as a function of degree of arterial stenosis (fig. 1). It was routinely combined with Doppler velocimetry and ultrasound imaging in 35 patients, a total of 64 carotid bifurcations being analyzed. Digital subtraction venous angiography was performed in 28 of these cases. Study of the reading effect on interpretation of the spectral analysis showed 37 agreements and 27 divergences; among the latter the definition of normality in relation to grades I or II appears to be responsible. Greater significance was noted for the reading effect in cases explored by Doppler velocimetry and ultrasonography. Positive findings were obtained with spectral analysis in 41 of 64 patients, either by detection of non-significant lesions or by precise quantification of stenotic lesions. Results of digital subtraction angiography were debatable in 8 of 28 patients and were unconfirmed on ultrasound imaging. Spectral analysis of the Doppler signal has therefore an advantage over Doppler velocimetry and ultrasonography in that more precise data is obtained on stenotic lesions and that those of little significance are detected. It supplies an effective means of diagnosis and surveillance and it establishes the need for angiography. Lack of sensitivity and reproducibility of ultrasound and digital subtraction venous angiography raises the problem of an effective reference test.(ABSTRACT TRUNCATED AT 250 WORDS)