Duplex scanning diagnosis of internal carotid artery dissections. A case control study.
BACKGROUND
The reliability of duplex scanning (DS) for the diagnosis of internal carotid artery dissections (ICAD) is not clear.


METHODS
Nine DS signs known to be suggestive for the diagnosis of ICAD were compared between 70 patients with ICAD and 70 matched patients without dissection.


RESULTS
Visible internal tapering occlusion, regular eccentric narrowing channel, ectasia beyond the carotid bulb, resistive index asymmetry, blood flow slowdown, ophthalmic artery blood flow inversion, and biphasic flow are more frequent in cases than in controls (p < 0.001). Atheroma plaques were absent in 80% of ICAD. When DS direct signs and hemodynamic signs were studied, sensitivity was 90% and specificity 60%.


CONCLUSIONS
Diagnosis of ICAD by DS could be improved if direct signs were combined with hemodynamic signs, giving a high sensitivity and a rather good specificity.
Alecu
C
C
Neurology Department, University Hospital, Nancy, France. c.alecu@chu-nancy.fr
Fortrat
J O
JO
Ducrocq
X
X
Vespignani
H
H
de Bray
J M
JM
D000328:Adult; D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D019992:Databases as Topic; D005260:Female; D005602:France; D006801:Humans; D017078:Laser-Doppler Flowmetry; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D018615:Ultrasonography, Doppler, Color; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*