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We examined 63 patients with 31 symptomatic and 44 asymptomatic carotid stenoses with Doppler color-flow imaging(DCFI);conventional Doppler duplex had shown a hemodynamic obstruction(>/=80%stenosis)in all patients. Analysis of plaque surface morphology demonstrated more ulcerated plaques in symptomatic(43%)than asymptomatic(23%)stenoses.Although the frequency of homogeneous and heterogeneous plaques was not different,calcific lesions were more frequent in asymptomatic(46%versus 29%),and echolucent plaques,probably indicating mural thrombi,were more frequent in symptomatic(29%versus 11%)stenosis.Color-coded hemodynamic patterns,such as jet flow,poststenotic turbulence,or reversed flow,were not different in symptomatic and asymptomatic stenoses.Comparison of DCFI with 30 angiograms showed agreement in plaque surface analysis in 70%.DCFI measurements of area reduction in cross sections correlated with angiography in 85%,while DCFI tended to underestimate the degree of stenosis from diameter reduction in longitudinal cuts.The advanced DCFI technique identified distinct morphologic features but no hemodynamic patterns,separating symptomatic from asymptomatic high-grade carotid stenoses. |
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carotid angiogram
carotid artery
carotid artery disease
carotid artery disease,asymptomatic
carotid artery disease,noninvasive evaluation of
carotid artery plaque
carotid artery stenosis
carotid artery stenosis,symptomatic
carotid artery ulceration
doppler
doppler,color
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