Comparison of digital subtraction computed tomography angiography and color doppler ultrasound on the detection rate of carotid atherosclerosis plaques and the evaluation of plaque properties and stenosis degree

Objective: To compare the value of digital subtraction computed tomography angiography (DSCTA) and color doppler ultrasound (CDUS) in the detection of carotid atherosclerotic plaques, plaque properties, and degree of stenosis. Methods: A total of 90 patients suspected with carotid artery stenosis were diagnosed in the department from January 2015 to October 2017 and examined with DSCTA and CDUS. The detection rates and plaques of carotid atherosclerotic plaques diagnosed by the two methods were observed. The nature and degree of carotid artery stenosis were compared. Results: DSCTA examination of bilateral neck of the 90 patients revealed 52 carotid artery stenosis, 3 of which were bilateral stenosis. A total of 29 cases were diagnosed with mild stenosis, 9 cases with moderate stenosis, 12 cases with severe stenosis, and 2 cases with complete occlusion. A total of 175 plaques, including 133 calcified plaques, 30 mixed plaques, and 12 plaques, were detected. In the 90 necks of both necks, CDUS findings revealed 54 carotid stenosis, of which 3 were bilateral stenosis. Mild stenosis occurred in 26 cases, moderate stenosis in 10 cases, severe stenosis in 16 cases, and complete occlusion in 2 cases. A total of 218 plaques were detected, and they included 138 calcified plaques, 39 mixed plaques, and 41 plaques. No significant difference was observed between DSCTA and CDUS in terms of diagnosis of carotid stenosis (x² = 0.75, P = 0.861). For most of the visible plaques and lipid plaques, the detection rate of < 5 mm small plaques (60) was significantly higher than that of DSCTA (25) (x² = 10.035, P = 0.002). Conclusions: The two diagnostic methods feature high diagnostic capability for carotid stenosis and desirable clinical application value. CDUS was superior to DSCTA in detecting carotid atherosderotic plaque < 5 mm in diameter. (authors)