DIAGNOSTIC ACCURACY OF CAROTID DOPPLER ULTRASOUND FOR DIAGNOSIS OFCAROTID STENOSIS TAKING COMPUTED TOMOGRAPHY ANGIOGRAPHY AS A GOLDSTANDARD
DOI:
https://doi.org/10.71000/y1fz3610Keywords:
Atherosclerosis, Carotid Artery Diseases, Carotid Doppler Ultrasound, Carotid Stenosis, Computed Tomography Angiography, Diagnostic Accuracy, Stroke, Ultrasonography.Abstract
Background: Carotid artery stenosis, resulting from atherosclerotic narrowing of the carotid arteries, is a major cause of ischemic stroke and transient ischemic attacks. Early and accurate diagnosis of this condition is essential to prevent cerebrovascular complications. Carotid Doppler ultrasound (CDUS) and computed tomography angiography (CTA) are commonly used imaging modalities for detecting carotid stenosis, with CTA regarded as the gold standard. This study aimed to assess the diagnostic accuracy of CDUS in detecting carotid artery stenosis using CTA as the reference standard.
Objective: To determine the diagnostic accuracy, sensitivity, specificity, and predictive values of carotid Doppler ultrasound for the detection of carotid artery stenosis, using computed tomography angiography as the gold standard.
Methods: This cross-sectional validation study was conducted in the Radiology Department of Khyber Teaching Hospital, Peshawar, over six months following ethical approval. A total of 125 patients aged 25–80 years with symptoms suggestive of carotid stenosis were enrolled through non-probability consecutive sampling. Each patient underwent both CDUS and CTA. Findings from both modalities were compared to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy. Data were analyzed using IBM SPSS v27, with p ≤ 0.05 considered statistically significant.
Results: The mean age of participants was 58.7 ± 10.9 years, with 60.8% males. Carotid stenosis was detected in 28.8% of patients on CDUS and 27.2% on CTA. CDUS showed a sensitivity of 88.2%, specificity of 93.4%, PPV of 83.3%, NPV of 95.6%, and overall diagnostic accuracy of 92.0%. The prevalence of stenosis was higher among smokers, hypertensive, and diabetic patients.
Conclusion: Carotid Doppler ultrasound demonstrated high diagnostic accuracy compared to computed tomography angiography, supporting its role as a reliable, non-invasive, and cost-effective screening tool for carotid artery stenosis in clinical practice.
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