title: Color-flow Doppler sonography in the identification of ulcerative plaques in patients with high-grade carotid artery stenosis.
abstract: OBJECTIVE
  To assess the ability of color-flow Doppler sonography (CFDS) to detect plaque ulcerations in patients who had high-grade to thread-like carotid artery stenosis and who underwent carotid endarterectomy.
  
  
  METHODS
  CFDS is a noninvasive diagnostic technique that allows, in addition to spatial visualization of blood flow, the identification of abnormal blood flow patterns such as vortex formation. There is evidence that pathologic anatomic changes in the vascular wall (such as ulcerations) may result in characteristic hemodynamic alterations. Therefore, solely hemodynamic criteria (detection of vortices) were used to diagnose ulceration. The results of preoperative examinations were compared to the intraoperative findings in 89 patients in a prospective and blinded way.
  
  
  RESULTS
  CFDS proved highly sensitive (95.3%), specific (93.5%), and accurate (94.0%) for demonstrating ulcerative plaques.
  
  
  CONCLUSIONS
  CFDS may be of significant advantage for examining plaque morphology in patients who have high-grade internal carotid artery stenosis, and in whom accurate, noninvasive diagnosis of plaque ulceration was previously difficult, if not impossible.
authors.affiliation: Department of Surgery, Klinikum Grosshadern, Ludwig-Maximilian University School of Medicine, Munich, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Fürst
authors.forename: W H
authors.initials: WH
authors.lastname: Hartl
authors.forename: I
authors.initials: I
authors.lastname: Jansen
authors.forename: D
authors.initials: D
authors.lastname: Liepsch
authors.forename: L
authors.initials: L
authors.lastname: Lauterjung
authors.forename: F W
authors.initials: FW
authors.lastname: Schildberg
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D014463:Ultrasonography