Three-dimensional color Doppler sonography in carotid artery stenosis.
OBJECTIVE
Color Doppler sonography (CDS) suffers from such disadvantages as high interobserver variability and problems with data presentation and storage. We therefore performed a prospective trial to assess the role of three-dimensional CDS (3D-CDS) in the evaluation of internal carotid artery stenosis (ICAS).


METHODS
We included 32 consecutive patients with sonographically verified ICAS (30-99%) and 16 asymptomatic volunteers. All underwent CDS and 3D-CDS, and 23 patients also underwent intraarterial angiography. The sensitivity, specificity, positive predictive value, and negative predictive value for the detection of high-grade ICAS were analyzed by three blinded readers, who also graded the percentage of ICAS.


RESULTS
CDS revealed 14 patients with mild to moderate ICAS and 18 patients with high-grade ICAS. Mean sensitivity of 3D-CDS was 81.5%, mean specificity was 98.9%, mean positive predictive value was 97.9%, and mean negative predictive value was 89.9%. 3D-CDS correlated significantly with CDS (mean r=0.85; P<.001) and angiography (mean r=0.57; P=.01).


CONCLUSIONS
3D-CDS findings correlate with those obtained by CDS and angiography; 3D-CDS also offers excellent interobserver correlation, positive predictive value, and specificity, approaching 100% for the detection of high-grade ICAS.
Bucek
Robert A
RA
University Clinic for Radiology, Department of Angiography and Interventional Radiology, Vienna General Hospital, Vienna, Austria.
Reiter
Markus
M
Dirisamer
Albert
A
Haumer
Markus
M
Fritz
Angelika
A
Minar
Erich
E
Lammer
Johannes
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001783:Blood Flow Velocity / Q000502:physiology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013223:Statistics as Topic; D018615:Ultrasonography, Doppler, Color