Use of ultrasound contrast in the diagnosis of carotid artery occlusion

Objective: The purpose of this study was to evaluate the use of an echo-enh ancing agent in patients with carotid artery occlusion to improve the sensi tivity and specificity of carotid color flow ultrasonography Method: Between January 1997 and December 1998, a prospective study involvi ng 85 cases of carotid artery occlusion in 84 patients was carried out. Aft er a baseline duplex ultrasonography (DU) diagnosis, a second (DU) along wi th an echo-enhancement agent (SHU-508-A [Levovist]) study was carried out ( echo enhancement ultrasonography diagnosis [DUEE]). In 82 cases, a contrast angiography was performed to confirm the diagnosis, whereas in the other t hree cases the diagnoses mere confirmed with surgery. Results: From the 85 internal carotid artery occlusions diagnosed at the in itial DU examination, seven came out to be false occlusions in the DUEE exa mination (8,2%). There was a 100% correlation of the cases between the DUEE examination and the contrast angiography in the 82 cases in which this had been done. In three of the cases, the diagnosis was confirmed surgically b ecause these displayed severe stenoses according to the DUEE studies in sym ptomatic patients, and so they required urgent treatment. Conclusions: The DUEE study is a potent diagnosis tool that allows the diff erentiation between hue carotid artery occlusions and pseudo-occlusions.