title: Duplex ultrasonography is an efficient diagnostic tool for the detection of moderate to severe internal carotid artery stenosis.
abstract: BACKGROUND
  The aim of this prospective national multicentre study with 10 participating university and county hospitals was to establish the diagnostic accuracy of carotid duplex sonography in the identification of >or=70% internal carotid artery (ICA) stenosis defined according to European Carotid Surgery Trial (ECST) criteria.
  
  
  METHODS
  In 134 patients, aged 69 +/- 9 years, ICA stenoses were identified by routine carotid duplex ultrasonography, confirmed angiographically within 2 months, and graded according to ESCT criteria. The accuracy of carotid duplex to detect ICA stenosis >or=70% was assessed using receiver operating characteristic (ROC) analysis with carotid angiography as a reference.
  
  
  RESULTS
  Measurement of peak systolic velocity in ICA (PSV(ICA)) identified ICA stenosis >or=70% with high diagnostic accuracy that was Doppler angle dependent resulting in different optimal PSV(ICA) cut points within the angle range 0 degrees -49 degrees (1 x 7 m s(-1)) and 50 degrees -62 degrees (2 x 3 m s(-1)). The diagnostic discrimination was significantly better when narrow Doppler angles (0 degrees -49 degrees ) were used (P<0 x 01) providing the sensitivity of 98 +/- 2% and specificity of 94 +/- 4%.
  
  
  CONCLUSIONS
  Ultrasound duplex technique identifies moderate to severe (>or=70%) ICA stenoses (ECST criteria) with high degree of accuracy that can be further improved by the use of Doppler angle specific optimal PSV(ICA) cut points.
authors: Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, Karolinska University Hospital in Huddinge, Stockholm, Sweden. jacek.nowak@ki.se
authors: Jacek
authors: J
authors: Nowak
authors: Tomas
authors: T
authors: Jogestrand
mesh_terms: D000368:Aged; D000792:Angiography; D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*