Doppler ultrasound and contrast-enhanced magnetic resonance angiography in assessing carotid artery stenosis.
OBJECTIVE
This study prospectively compares Doppler ultrasound (Doppler US) and contrast-enhanced magnetic resonance angiography (CE-MRA) with digital subtraction angiography (DSA) and endarterectomy findings to determine the accuracy in assessing carotid artery stenosis.


METHODS
Thirty-two patients underwent carotid endarterectomy, 21 studied with Doppler US, CE-MRA and DSA and 11 with Doppler US and CE-MRA. In 41 carotid arteries, the degree of stenosis was analysed with Doppler US and CE-MRA and compared with DSA by using the Spearman rank correlation coefficient. Nine out of 32 endarterectomies were done using the eversion technique, and it was possible to compare Doppler US, CE-MRA and DSA with the specimen measurement. Twenty-three out of 32 endarterectomies were done using the standard technique, and the presence of ulcers was documented.


RESULTS
There was a significant Doppler US/DSA (Rs=0.86; p<0.001) and CE-MRA/DSA (Rs=0.81; p<0.001) correlation for the degree of stenosis. The diagnostic accuracy of the three methods was the same (89%). Ulcers were most frequently seen at CE-MRA, with a diagnostic accuracy of 85%.


CONCLUSIONS
These data suggest that endarterectomy on the basis of Doppler US and CE-MRA can be considered appropriate. CEMRA was the best noninvasive imaging modality to detect plaque ulceration.
D'Onofrio
M
M
Istituto di Radiologia, Policlinico G.B. Rossi, Università di Verona, P.le L.A. Scuro 10, I-37134 Verona, Italy. mirko.donofrio@univr.it
Mansueto
G
G
Faccioli
N
N
Guarise
A
A
Tamellini
P
P
Bogina
G
G
Pozzi Mucelli
R
R
D015901:Angiography, Digital Subtraction; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D003287:Contrast Media; D016894:Endarterectomy, Carotid; D006801:Humans; D018810:Magnetic Resonance Angiography; D008536:Meglumine; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler
D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine