Assessment of carotid artery stenosis – Comparative Analysis between Duplex Ultrasonography and CT Angiography

Carotid atherosclerosis is the leading cause for development of neurological insufficiency. All imaging modalities for carotid lesions have advantages and disadvantages. However, the accuracy of these modalities is still controversial. The aim of this study was to evaluate the diagnostic capabilities of Colour Coded Duplex Ultrasonography (CCDUS) and Computed Tomography Angiography (CTA) in patients with carotid artery stenotic or occlusive disease. For a period of 5 years in the Clinic of Vascular and Endovascular Surgery of University Hospital "St. Ekaterina" – Sofia, we studied 150 patients with carotid artery stenosis or occlusion. Diagnostic protocol in all patients included CCDUS and subsequent CTA. The mean age of the study group was 64.46±8.54 years. Correlation analysis was applied and data validation of screening test criteria were evaluated. No statistically significant difference was found between the mean values of the measurements performed with the two imaging modalities, which is also confirmed by the correlation analysis for both operated (Spearman's ρ = 0.903, p < 0.001) and contralateral (Spearman's ρ = 0.987, p < 0.001) carotid artery. By examining the validation criteria using CCDUS versus CTA high values of sensitivity, specificity, positive and negative predictive value, and accuracy were established. In conclusion our study gives us ground to conclude that CCDUS can be used as a reliable substitute for the relatively high-risk CTA study. Key words: assessment of the carotid artery stenosis or occlusions, Colour Coded Duplex Ultrasonography, Computed Tomography Angiography