title: Diagnostics and characterisation of preocclusive stenoses and occlusions of the internal carotid artery with B-flow.
abstract: The purpose was to evaluate whether B-flow can improve the ultrasonographic diagnosis of preocclusive stenosis and occlusion of the internal carotid artery (ICA) compared with colour-coded Doppler and power Doppler. Ninety patients with occlusions or preocclusive stenoses of the ICA suspected by Doppler sonography were examined with B-flow in comparison with colour-coded Doppler sonography (CCDS), power Doppler (PD) and intra-arterial digital subtraction angiography (DSA). Intrastenotic flow detection and lengths of stenoses were the main criteria. Ulcerated plaques found by surgery in 42/90 patients were compared by ultrasonography (US). Diagnosis of ICA occlusion with CCDS, PD and B-flow was correct in all 42 cases. A preocclusive ICA stenosis in DSA was detected correctly in all 48/48 cases (100%) for B-flow, in 44/48 (92%) for PD and in 39/48 (81%) for CCDS. Surgical findings showed in 17/42 cases ulcerated plaques; 15/17 (89%) of these cases were detected with B-flow, 12/17 (71%) with PD, 10/17 (59%) with CCDS, and 8/17 (47%) with DSA. With B-flow the extent of stenosis was appraised more precisely than with PD and CCDS (P<0.0001). In conclusion, B-flow is a reliable method for preocclusive stenosis of the ICA with less intrastenotic flow artefacts. B-flow facilitates the characterization of plaque morphologies.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Klinikum Passau, Innstrasse 76, 94032 Passau, Germany. emjung@web.de
authors.forename: E M
authors.initials: EM
authors.lastname: Jung
authors.forename: R
authors.initials: R
authors.lastname: Kubale
authors.forename: G
authors.initials: G
authors.lastname: Ritter
authors.forename: M T
authors.initials: MT
authors.lastname: Gallegos
authors.forename: K-P
authors.initials: KP
authors.lastname: Jungius
authors.forename: N
authors.initials: N
authors.lastname: Rupp
authors.forename: D-A
authors.initials: DA
authors.lastname: Clevert
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003097:Collateral Circulation; D003951:Diagnostic Errors; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012107:Research Design; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods