Does color-flow imaging improve the accuracy of duplex carotid evaluation?

• Published in: Journal of vascular surgery Vol. 13; no. 5; pp. 659 - 663
• Main Authors: Londrey, Gregg L., Spadone, Donald P., Hodgson, Kim J., Ramsey, Don E., Barkmeier, Lynne D., Sumner, David S.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01.05.1991; Elsevier
• Subjects: Angiography; Biological and medical sciences; Carotid Artery, Internal - diagnostic imaging; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Nervous system; Reproducibility of Results; Ultrasonic investigative techniques; Ultrasonography - methods; Sonography; Human; Nervous system diseases; Carotid; Color; Stenosis; Hemodynamics; Cerebrovascular disease
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/0741-5214(91)90350-4

To determine whether color-flow imaging enhances the accuracy of noninvasive carotid evaluation, the results of carotid duplex examinations from two laboratories, one with color-flow and the other with standard duplex imaging were compared. The techniques used by both laboratories were identical. All studies were interpreted by one of the authors, using the same criteria. From October 1988 through December 1989, 307 internal carotid arteries were evaluated with both color-flow imaging and standard angiography; and 206 underwent routine duplex scanning and angiography. Perfect agreement between test and angiographic results was significantly better with color-flow (86.6%) than with conventional duplex scanning (79.6%), p = 0.034 (t test for independent samples). Significantly fewer vessels were over classified by one category with color-flow (8.5%) than with routine duplex scanning (16.5%), p = 0.006. However, no difference was found in the number underclassified by one category (4.5% vs 3.4%), p = 0.5. Although these data support the accuracy of both modalities, there appears to be a trend toward improved results with the newer method. We attribute this to more precise placement of the pulsed Doppler sample volume afforded by the color-flow image.