Comparison of Duplex Ultrasound with Angiography in Assessment of Carotid Bifurcation Disease

This is a study comparing duplex ultrasound against the "gold standard" of angiography in assessing atherosclerotic disease of the carotid bifurcation, prior to prospective endarterectomy surgery. Thirty-nine patients were studied with both sonography and angiography studies being performed within one month of each other. Plaques were described by sonography as being "smooth" or "irregular" in surface and "homogeneous" or "heterogeneous" in composition. Ultrasound showed an overall 92% sensitivity, against the standard of angiography, in its ability to assess the degree of internal carotid stenosis. There was only a 63% sensitivity with the common carotid arteries and only a 65% sensitivity with the external carotid arteries. Ultrasound did not show a high accuracy in detecting plaque ulceration when compared against angio-graphy.