Screening for High-grade Carotid Stenosis Using a Portable Ultrasonography Instrument

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00044.x Byline: Ulf Schminke (1), Lillian Motsch (1), Li-Ming Lien (1), Teng-Yeow Tan (1), M. Gene Bond (1), James F. Toole (1), Charles H. Tegeler (1) Keywords: Screening; ultrasonography; power Doppler imaging; carotid artery stenosis Abstract: ABSTRACT Background and Purpose. We investigated the diagnostic performance of a brief Power Doppler Imaging (PDI) screening examination for carotid artery stenoses using a newly developed portable instrument. Methods. A highly experienced sonographer screened in total 152 carotid arteries by either continuous wave (cw) Doppler (n= 50) or a lightweight (2.4 kg) portable duplex device (n= 102) in a prospective study of 76 high-risk patients. The screening protocols included either spectrum analysis and frequency shift measurement in both internal carotid arteries with cw-Doppler or determination of area and diameter ratios in transverse and longitudinal views of both carotid arteries in B-mode and with PDI, but without velocity measurement. Both protocols were evaluated against a complete routine duplex ultrasonography examination. Results. According to the complete examination, stenoses were Conclusions. The diagnostic performance of the cw-Doppler protocol was superior to the PDI protocol. Nevertheless, both protocols appear suitable as inexpensive screening strategies to identify subjects with >75% stenosis measured by carotid Doppler ultrasound. However, these preliminary data need further verification. Author Affiliation: (1)From the Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, USA (US, LM, L-ML, T-YT, JFT, CHT); Division of Vascular Ultrasound Research, Department of Neurobiology and Anatomy, Wake Forest University Baptist Medical Center, Winston-Salem, USA (MGB); Department of Neurology, Ernst Moritz Arndt University, Greifswald, Germany (US, LM); Department of Neurology, Shin Kong WHS Memorial Hospital, Taipei, Taiwan (L-ML); and Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan (T-YT). Article History: Received December 14, 2004, and in revised form August 10, 2005, December 8, 2005 and March 13, 2006. Accepted for publication March 16, 2006. Article note: Address correspondence to Ulf Schminke, MD, Department of Neurology, Sigmaringen Hospital, Hohenzollernstrasse 40, D-72488 Sigmaringen, Germany. E-mail: u.schminke@klksig.de, UlfSchminke@aol.com.