title: Validation of a basic neurosonology laboratory for detecting cervical carotid artery stenosis.
abstract: BACKGROUND
  Most of the cases of ischaemic stroke in our setting are of atherothrombotic origin. Detecting intracranial and cervical carotid artery stenosis in patients with ischaemic stroke is therefore essential. Ultrasonography has become the tool of choice for diagnosing carotid artery stenosis because it is both readily accessibility and reliable. However, use of this technique must be validated in each laboratory. The purpose of this study is to validate Doppler ultrasound in our laboratory as a means of detecting severe carotid artery stenosis.
  
  
  METHODS
  We conducted an observational descriptive study to evaluate diagnostic tests. The results from transcranial and cervical carotid Doppler ultrasound scans conducted by neurologists were compared to those from carotid duplex scans performed by radiologists in patients diagnosed with stroke. Arteriography was considered the gold standard (MR angiography, CT angiography, or conventional arteriography).
  
  
  RESULTS
  Our sample included 228 patients. Transcranial and cervical carotid Doppler ultrasound showed a sensitivity of 95% and specificity of 100% for detection of carotid artery stenosis > 70%, whereas carotid duplex displayed a sensitivity of 87% and a specificity of 94%. Transcranial carotid Doppler ultrasound achieved a sensitivity of 78% and a specificity of 98% for detection of intracranial stenosis.
  
  
  CONCLUSIONS
  Doppler ultrasound in our neurosonology laboratory was found to be a useful diagnostic tool for detecting cervical carotid artery stenosis and demonstrated superiority to carotid duplex despite the lack of B-mode. Furthermore, this technique was found to be useful for detecting intracranial stenosis.
authors.affiliation: Servicio de Neurología, Hospital Universitario Virgen de la Victoria, Málaga, España. Electronic address: carlosdelacruzcosme@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: de la Cruz Cosme
authors.affiliation: Unidad de Neurofisiología del Sistema Nervioso Autónomo, CIMES, Universidad de Málaga, Málaga, España.
authors.forename: M S
authors.initials: MS
authors.lastname: Dawid Milner
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, España.
authors.forename: G
authors.initials: G
authors.lastname: Ojeda Burgos
authors.affiliation: FIMABIS (Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud), Málaga, España.
authors.forename: A
authors.initials: A
authors.lastname: Gallardo Tur
authors.affiliation: Servicio de Neurología, Hospital Universitario Virgen de la Victoria, Málaga, España.
authors.forename: M
authors.initials: M
authors.lastname: Márquez Martínez
authors.affiliation: Servicio de Neurología, Hospital Universitario de Albacete, Albacete, España.
authors.forename: T
authors.initials: T
authors.lastname: Segura
mesh_terms: D000368:Aged; D000792:Angiography; D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D020521:Stroke; D017585:Ultrasonography, Doppler, Transcranial / Q000592:standards*
keywords: Arteriosclerosis intracraneal; Carotid artery disease; Carotid artery stenosis; Doppler ultrasound; Enfermedades de la arteria carótida; Estenosis carotídea; Estenosis intracraneal; Intracranial arteriosclerosis; Intracranial stenosis; Intracranial thrombosis; Trombosis intracraneal; Ultrasonografía Doppler