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Near-occlusion is difficult to diagnose with common carotid ultrasound methods
Umeå University, Faculty of Medicine, Wallenberg Centre for Molecular Medicine at Umeå University (WCMM). Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.ORCID iD: 0000-0001-5317-4563
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.ORCID iD: 0000-0003-2078-3658
Umeå University, Faculty of Medicine, Department of Clinical Sciences.
Umeå University, Faculty of Medicine, Department of Clinical Sciences.
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2021 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 63, no 5, p. 721-730Article in journal (Refereed) Published
Abstract [en]

Purpose: To assess the sensitivity and specificity of common carotid ultrasound method for carotid near-occlusion diagnosis.

Methods: Five hundred forty-eight patients examined with both ultrasound and CTA within 30 days of each other were analyzed. CTA graded by near-occlusion experts was used as reference standard. Low flow velocity, unusual findings, and commonly used flow velocity parameters were analyzed.

Results: One hundred three near-occlusions, 272 conventional ≥50% stenosis, 162 <50% stenosis, and 11 occlusions were included. Carotid ultrasound was 22% (95%CI 14–30%; 23/103) sensitive and 99% (95%CI 99–100%; 442/445) specific for near-occlusion diagnosis. Near-occlusions overlooked on ultrasound were found misdiagnosed as occlusions (n = 13, 13%), conventional ≥50% stenosis (n = 65, 63%) and < 50% stenosis (n = 2, 2%). No velocity parameter or combination of parameters could identify the 65 near-occlusions mistaken for conventional ≥50% stenoses with >75% sensitivity and specificity.

Conclusion: Near-occlusion is difficult to diagnose with commonly used carotid ultrasound methods. Improved carotid ultrasound methods are needed if ultrasound is to retain its position as sole preoperative modality.

Place, publisher, year, edition, pages
Springer, 2021. Vol. 63, no 5, p. 721-730
Keywords [en]
Carotid near-occlusion, Carotid stenosis, CT-angiography, Ultrasound
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:umu:diva-181829DOI: 10.1007/s00234-021-02687-xISI: 000628459000001PubMedID: 33715027Scopus ID: 2-s2.0-85102687199OAI: oai:DiVA.org:umu-181829DiVA, id: diva2:1542148
Note

Errata: Johansson, E., Vanoli, D., Bråten-Johansson, I. et al. Correction to: Near-occlusion is difficult to diagnose with common carotid ultrasound methods. Neuroradiology 63, 823 (2021). https://doi.org/10.1007/s00234-021-02696-w

Available from: 2021-04-06 Created: 2021-04-06 Last updated: 2022-05-05Bibliographically approved

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Johansson, EliasVanoli, Davide

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Wallenberg Centre for Molecular Medicine at Umeå University (WCMM)NeurosciencesSection of MedicineDepartment of Clinical Sciences
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