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Journal of Ultrasound in Medicine, Vol 9, Issue 6 345-349, Copyright © 1990 by American Institute of Ultrasound in Medicine
Duplex carotid sonography. Peak systolic velocity in quantifying internal carotid artery stenosis
C. E. Withers, B. B. Gosink, A. M. Keightley, G. Casola, A. A. Lee, E. vanSonnenberg, J. F. Rothrock and P. D. Lyden
Department of Radiology, University of California Medical Center, San Diego.
Duplex ultrasonography combining high-resolution imaging and Doppler
spectrum analysis was performed in 92 consecutive patients (total, 180
vessels) and compared with the findings of conventional arteriography. All
duplex studies were categorized into four groups based upon the maximum
internal carotid artery (ICA) velocity: group 1: less than 125 cm/sec;
group 2: 125 to 224 cm/sec; group 3: greater than 225 cm/sec; and group 4:
no flow. Sensitivities and specificities were highest when peak ICA
velocity was used as one of several criteria in quantifying the degree of
ICA stenosis. These additional criteria were: (1) the presence of extensive
sonographically visible plaque within the ICA; (2) an abnormal spectral
waveform with elevated diastolic velocity (greater than 100 cm/sec); (3)
resistive pattern ("externalization") of the common carotid artery (CCA)
waveform; and (4) the ratio of the right CCA peak velocity to the left of
less than 0.7 or greater than 1.3. The overall accuracy for the combined
groups using all criteria was 94%.
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