Evaluation of ulceration in the extracranial carotid artery with ultrasonography: A comparison with arteriography

The accuracy of duplex-scanning and angiography in detecting ulceration in the carotid arteries was evaluated. Sixty-nine patients underwent duplex-scanning and carotid arteriography, and the findings were blindly compared to the operative specimens. Duplex-scanning had a significantly higher sensitivity (90 vs 48%, P vs 59%, P vs 89%, P = 0.28). Comparison was also made between conventional arch angiography and selective carotid angiography in detecting ulceration. There was no significant difference between the methods (sensitivity 47 vs 50%, specificity 82 vs 100%). Finally, inter-observer variability in detecting ulceration with duplex-scanning was evaluated in double-blind evaluation of the duplex-scans. The interobserver agreement was 84%. Duplex-scanning seems to be superior to angiography in detecting ulcerations in the extracranial carotid artery.