ACTA FAC. MED. NAISS. 2006; 23 (1): 31-38

   Original article

THE SIGNIFICANCE OF COLOR DOPPLER SONOGRAPHY IN SELECTION OF PATIENTS FOR CAROTID ENDARTERECTOMY

Sladjana Petrovic¹, Dragan Petrovic², Zoran Rancic³, Miroslava Zivkovic⁴, Aleksandar Bojanovic¹, Dragana Budjevac³

¹Institute of Radiology, Clinical Center Nis, Serbia ,
²Department of Maxillofacial surgery, Clinic of Stomatology Nis, Serbia
³Clinic of Surgery, Clinical Center, Nis, Serbia
⁴Clinic of Neurology, Clinical Center, Nis, Serbia

    SUMMARY

    Sonography is the most widespread diagnostic procedure in obstructive disease of the arteries supplying the brain. The combined non-invasive information on morphology and function makes color Doppler sonography the procedure of choice in screening and follow-up of carotid artery disease. The aim of this study was to establish the significance of color Doppler sonography in selection of patients for carotid endarterectomy. Sonographic examinations of carotid arteries were performed in 5124 patients. The series consisted of all the patients with symptoms of carotid disease as well as asymptomatic patients with some risk factor. The examination was done on conventional ultrasound machines and linear 7,5 MHz transducers with color Doppler imaging. Ultrasound examinations aimed at establishing the presence and locus of the plaque, length of involved segment, degree of stenosis, plaque structure and plaque surface configuration. Stenosis degree determination was computer-assisted using two morphological and one hemodynamical methods of stenosis grading. In some cases, ultrasound findings were compared to DSA findings, and all ultrasound findings were compared to intraoperative ones. Out of the total number of examinees, 0.9% patients were selected based on surgically significant stenosis (over 75%). In cases in which angiography of the carotid bed was performed too, ultrasound findings correlated well with angiography. Ultrasound findings correlated well with intraoperative findings, too. The significance of color Doppler sonography in patient selection for carotid endarterectomy lies in the possibility of direct visualization of plaque morphology, determination of its properties, and the composition of configuration of its surface, which cannot be measured with other diagnostic procedures. Moreover, it is possible to measure the length of stenosis-involved segment, to determine precisely the grade of stenosis and to get an insight into homodynamic disorders.

    Key words: carotid endarterectomy, stenosis, color Doppler sonography