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VASCULAR IMAGING Table of Contents   
Year : 2005  |  Volume : 15  |  Issue : 1  |  Page : 91-98
Color and duplex doppler imaging evaluation of extracranial carotid artery in patients presenting with transient ischaemic attack and stroke : a clinical and radiological correlation.


Lady Hardinge Medical College and Associated Hospitals, New Delhi, India

Correspondence Address:
S K Sethi
C P-109, Pitampura, Maurya Enclave, Delhi-110088
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.28756

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OBJECTIVES -Present study was done to evaluate carotid artery disease by color and duplex imaging in 63 patients (126 vessels) presenting with transient ischaemic attack and stroke. METHODS Vessel wall thickness and plaque characterization were done by gray scale ultrasound and site and severity of stenosis was assessed on color and duplex Doppler. Doppler finding were correlated with clinical presentation, risk factors, CT and echocardiographic findings. RESULTS-Male sex (p<0.01), post menopausal state (p<0.05) Presence of hypertension (p<0.01), systolic blood pressure, smoking (p<0.05), diabetes mellitus (p<0.05), history suggestive of peripheral arterial disease (p<0.01), previous CVA (p<0.01) were determined to be statistically significant risk factors. All the patients with a carotid bruit had abnormal carotid Doppler. Mean cholesterol levels in patients with normal carotid arteries was 186.52 ( 36.88) mg% and mean cholesterol level in patients with carotid lesion was 219.11( 35.13) All patients with >40% stenosis had a cortical infarct, none of patients with >40% stenosis had a subcortical infarct. All 22 patients with sub cortical infarcts had either normal extra-cranial carotids or had <40% stenosis. . Majority of plaques (50%) in the present study were located at the bifurcation. Color Flow imaging showed a definite advantage over B-mode scanning in identification of the hypoechoic plaques and in identification of plaque ulcerations. The overall perfect agreement between Color Doppler Flow Imaging and Conventional Duplex scanning was 96.8%. In patients with complete occlusion findings of color flow imaging and spectral analysis were confirmed on power Doppler imaging. Mean IM thickness of patients with normal echocardiography was 0.9250 ( 0.2863) and IM thickness of patients with echocardiographic evidence of IHD was 1.3455 ( 0.2734). CONCLUSION-As progression of the atherosclerotic disease can be stopped by reducing the risk factors and critical (>70%) stenosis treated surgically present study highlights the importance of doppler imaging in stroke prevention through surveillance for atherosclerosis that predisposes a person to cerebral ischaemia.


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