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Carotid near-occlusion frequently has high peak systolic velocity on Doppler ultrasound

Khangure, Simon R. (author)
Benhabib, Hadas (author)
Machnowska, Matylda (author)
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Fox, Allan J. (author)
Grönlund, Christer (author)
Umeå universitet,Radiofysik
Herod, Wendy (author)
Maggisano, Robert (author)
Sjöberg, Anders (author)
Umeå universitet,Klinisk neurovetenskap,Radiofysik
Wester, Per (author)
Karolinska Institutet,Umeå universitet,Avdelningen för medicin,Department of Clinical Sciences, Karolinska Institutet Danderyds Hospital, Stockholm, Sweden
Hojjat, Seyed-Parsa (author)
Hopyan, Julia (author)
Aviv, Richard I. (author)
Johansson, Elias (author)
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 (creator_code:org_t)
2017-11-25
2018
English.
In: Neuroradiology. - : Springer. - 0028-3940 .- 1432-1920. ; 60:1, s. 17-25
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Purpose: Carotid near-occlusion is a tight atherosclerotic stenosis of the internal carotid artery (ICA) resulting in decrease in diameter of the vessel lumen distal to the stenosis. Near-occlusions can be classified as with or without full collapse, and may have high peak systolic velocity (PSV) across the stenosis, mimicking conventional > 50% carotid artery stenosis. We aimed to determine how frequently near-occlusions have high PSV in the stenosis and determine how accurately carotid Doppler ultrasound can distinguish high-velocity near-occlusion from conventional stenosis.Methods: Included patients had near-occlusion or conventional stenosis with carotid ultrasound and CT angiogram (CTA) performed within 30 days of each other. CTA examinations were analyzed by two blinded expert readers. Velocities in the internal and common carotid arteries were recorded. Mean velocity, pulsatility index, and ratios were calculated, giving 12 Doppler parameters for analysis.Results: Of 136 patients, 82 had conventional stenosis and 54 had near-occlusion on CTA. Of near-occlusions, 40 (74%) had high PSV (≥ 125 cm/s) across the stenosis. Ten Doppler parameters significantly differed between conventional stenosis and high-velocity near-occlusion groups. However, no parameter was highly sensitive and specific to separate the groups.Conclusion: Near-occlusions frequently have high PSV across the stenosis, particularly those without full collapse. Carotid Doppler ultrasound does not seem able to distinguish conventional stenosis from high-velocity near-occlusion. These findings question the use of ultrasound alone for preoperative imaging evaluation.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)

Keyword

Carotid stenosis
Ultrasonography
X-ray computed tomography
Angiography
Internal carotid artery
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