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Category: Volume 07 Issue 06 June 2019
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Title: Carotid Plaque: Looking Beyond Stenosis - A Comparison between Duplex Sonography and CT Angiography

Authors: Dr Arnav Shandil, Dr Nikita Verma, Dr Dinesh Sood, Dr Narvir S.Chauhan, Dr Ambuj Shandil

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.63

Abstract

Background and Objectives: Cerebrovascular disease with stroke in particular is one of the most important causes of death and the greatest cause of disability all over the world. Stenosis degree is considered the leading parameter in the choice of therapeutic options but factors other than the degree of stenosis are also important in assessing whether a carotid lesion will remain clinically silent. Ulcerated plaques are associated with a higher risk of embolism and occlusion, producing ischemic neurologic events.

The purpose of this study was to evaluate the diagnostic efficacy of multidetector row CT angiography (MDCTA) and US-ECD in the evaluation of carotid plaque complicated by ulceration with MDCT being taken as reference standard

Methods: Total of 30 patients with symptoms pertaining to cerebrovascular disease were selected over a period of one year and plaque ulceration was evaluated and compared by both Doppler ultrasound and CT angiography.

Results: We concluded that CDUS is inferior w.r.t CTA to assess plaque morphology and especially in identification of ulceration. This can be ascribed, in part, to the fact that acoustic shadowing from calcification obscures ulcers, and the sonography probe may not be parallel to the axis of the vessel in the region of the ulceration. Sonography is limited by its accuracy and reproducibility, especially when the lesion is calcified. The recent development of 3D US and the use of CEUS may help improve the detection of carotid ulceration

Keywords: Plaque ulceration, carotid vascular disease, cerebrovascular disease, Doppler ultrasound, CT angiography.

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Corresponding Author

Dr Ambuj Shandil

Civil Hospital Theog, Shimla, H.P (India)