What is the accuracy of ultrasound imaging for stenosis in stroke?

Updated: Nov 30, 2018
  • Author: Andrew Danziger; Chief Editor: L Gill Naul, MD  more...
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Answer

Duplex ultrasound is an excellent tool for screening the level of stenosis in the ICA above or below a single degree of severity. However, it is less accurate in specifically quantifying the degree of stenosis in a given carotid artery. Doppler ultrasound is least accurate in diagnosing moderate degrees of stenosis (50-69%), often overestimating the amount of stenosis in this category. [100, 101]

Transcranial Doppler ultrasonography has proven to be a very useful bedside method to evaluate cerebral blood flow noninvasively. This technique is of particular value for the detection of vasospasm following subarachnoid hemorrhage, for evaluating the cerebral circulation in occlusive disease of the carotid and vertebral arteries, and for even assessing vascular malformations. [102, 103, 104]  Intraoperative transcranial Doppler ultrasonography has enabled clinicians to lower the rate of serious carotid endarterectomy complications, such as thromboembolic stroke, from 4% to 0.2% through detection of the middle cerebral artery flow cessation due to the intraluminal carotid artery thrombosis. [99]


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