CT-angiography and doppler ultrasonography in atherosclerotic carotid artery disease. A comparative study

Background: Different diagnostic modalities to investigate atherosclerotic carotid artery disease (ACAD) are nowadays available. The aim of this study was to test the concordance of the findings of the two most widely used diagnostic modalities namely computed tomography angiography (CTA) and doppler ultrasonography (DUS). Material and methods: 29 patients with acute ischemic stroke were subjected to CTA and DUS and included in this analysis; 17 patients were males (59 %). The mean age was 70.5 ± 8 years (Mean ± SD). The correlation and the degree of concordance between the findings of CTA and DUS were tested. The associations between the occurrence of ACAD and the degree of severity of stenosis with the age, the gender and the side of stenosis were also tested. The statistical significance was set to < 0.05. Results: This study showed almost perfect agreement between CTA and DUS in detection of stenosis with kappa value of 0.92 (95 % CI 0.82–1.02). Intraclass correlation coefficient for the agreement between CTA and DUS in the estimation of the degree of stenosis was almost perfect and estimated to 0.96 (95 % CI 0.93–0.97). The differences of the measurements of the degree of carotid artery stenosis by the two methods was not statistically significant (p=0.04) with random error of 9.9 %. Spearman ́s correlation and linear regression showed strong correlation between the measurements of stenosis by CTA and DUS with P< 0.001, correlation coefficient of 0.933, and R linear of 0.92, respectively. The stenosis was more severe in males. Conclusion: CTA and DUS are noninvasive diagnostic modalities with good correlation with regard to the detection of ACAD and the estimation of the degree of stenosis and can be used separately or as complementary to each other in the workup of ACAD.