Comparison of Color Doppler Ultrasound and CT Angiography in Carotid Artery Stenosis: A Four Years’ Experience from a Single Medical Center

Background: Carotid artery stenosis is the main cause of stroke, and evaluating the degree of carotid artery stenosis is of utmost importance in this regard.

Objectives: The objective of this study is to compare color Doppler ultrasound (CD-US) and CT angiography in diagnosing carotid artery stenosis in patients referred to a medical imaging center.

Patients and Methods: A total of 198 carotid arteries were evaluated in 99 patients. Patients older than 40 years of age, who were referred to our medical imaging center for the evaluation of carotid stenoses between 2008 and 2012, were enrolled in this study. All patients were examined by CD-US, and if the plaque were present in CD-US, the patients were also examined by CT angiography. In our study, carotid stenosis location, degree of stenosis, stenosis length, calcification, ulcer, and dissection were evaluated. Sensitivity, specificity, and agreement of the two methods were assessed.

Results: Comparison results of CD-US and CT findings showed a specificity of 80.6%, sensitivity of 84.7%, and kappa coefficient of 0.60. The most common stenosis location was in the proximal portion of the internal carotid artery. Moreover, the agreement of the two methods in the 4th (70–99%) and 5th (100%) degrees stenosis was very good.

Conclusions: The agreement of the two methods was very good for stenosis degree. CD-US had low sensitivity in comparison with CTA in the evaluation of calcification and ulcer. As a result, CTA is a complementary method for CD-US to show calcified plaques and ulcers.