Vojnosanitetski pregled 2011 Volume 68, Issue 5, Pages: 423-429
https://doi.org/10.2298/VSP1105423V
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Color doppler ultrasonography and multislice computer tomography angiography in carotid plaque detection and characterization
Vučaj-Ćirilović Viktorija (Clinical Center of Vojvodina, Radiology Department, Novi Sad)
Lučić Miloš (Vojvodina Institute of Oncology, Center for Imaging Diagnostics, Sremska Kamenica)
Petrović Kosta (Clinical Center of Vojvodina, Radiology Department, Novi Sad)
Nikolić Olivera (Clinical Center of Vojvodina, Radiology Department, Novi Sad)
Govorčin Mira (Clinical Center of Vojvodina, Radiology Department, Novi Sad)
Stojanović Sanja (Clinical Center of Vojvodina, Radiology Department, Novi Sad)
Beckground/Aim. Cerebrovascular diseases are the third leading cause of
mortality in the world, following malignant and cardiovascular diseases.
Therefore, their timely and precise diagnostics is of great importance. The
aim of this study was to compare duplex scan Color Doppler ultrasonography
(CDU) with multislice computed tomography angiography (MSCTA) in detection of
morphological and functional disorders at extracranial level of carotid
arteries. Methods. The study included 75 patients with 150 carotid arteries
examined in the period from January 2008 to April 2009. The patients were
firstly examined by CDU, then MSCTA, followed by the surgery of extracranial
segment of carotid arteries. In 10 patients, the obtained material was
referred for histopathological (HP) examination. We used both CDU and MSCT in
the analysis of: plaque surface, plaque structure, degree of stenosis, and
the presence of intraplaque hemorrhage. Results. The results obtained by CDU
and MSCTA were first compared between themselves, and then to intraoperative
findings. Retrospective analysis showed that MSCTA is more sensitive than CDU
in assessment of plaque surface (for smooth plaques CDU 89% : MSCTA 97%; for
plaques with irregular surface CDU 75% : MSCTA 87%; for ulcerations CDU 54% :
MSCTA 87%). Regarding determination of plaque structure (mixed plaque CDU 66%
: MSCTA 70%; correlation with HP findings CDU 94% : MSCTA 96%) and
localization (CDU 63% : MSCTA 65%), and in terms of sensitivity and
specificity, both methods showed almost the same results. Also, there is no
statistical difference between these two methods for the degree of stenosis
(CDU 96% : MSCTA 98%). Conclusion. Atherosclerotic disease of extracranial
part of carotid arteries primarily affects population of middle-aged and
elderly, showing more associated risk factors. Sensitivity and specificity of
CDU and MSCTA regarding plaque composition, the degree of stenosis and plaque
localization are almost the same. These results and the fact that there are
no adverse effects (high radiation dose) compared to MSCTA indicate that CDU
should be the initial method in diagnostic algorythm for carotid arteries.
Keywords: ultrasonography, doppler, color, cerebral angiography, carotid artery diseases, carotid stenosis, tomography, x ray computed
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