Doppler-Ultrasound and computed tomography correlation for quantification of carotid stenosis

Carotid disease is a major cause of cerebrovascular events. Risk is proportional to the extent and severity of atherosclerosis. Aim of this study was to assess the correlation between 64-multi-detector-row computed-tomography angiography (MDCTA) and Doppler ultrasound peak-systolic-velocity (DUS-PSV) in the quantification of stenosis. 116 consecutive patients were included; it was calculated the degree of carotid stenosis with the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method using MDCTA and DUS-PSV. MDCTA measurements of stenosis ranged from 35% to 95% (mean 67±16%). DUS-PSV ranged from 102 to 600 cm/s (mean 262±112 cm/s). A moderate correlation (r = 0.427) was found between MDCTA-NASCET stenosis and PSV values. At ROC curve analysis, PSV could significantly discriminate between stenoses ≥70% and <70% at MDCTA-NASCET measurement, with area under the curve of 0.807 (p<0.0001). PSV value ≥230 cm/s was identified as optimal cutoff to predict stenosis ≥70% at MDCTA, with a sensitivity of 71%, specificity of 83%, negative predictive value of 67% and positive predictive value of 82%. We found a reasonable concordance between MDCTA and DUS-PSV in quantifying carotid stenosis. PSV value of 230 cm/s is a reliable threshold to predict a >70% stenosis of MDCTA.