Comparison between 3D power Doppler ultrasound, color Doppler ultrasound and digital subtraction angiography in carotid artery disease.

Purpose: To compare easy-to-perform three-dimensional power Doppler ultraso und (3D PDUS) to color Doppler ultrasound (CDUS) and digital subtraction an giography (DSA) in the assessment of internal carotid artery (ICA) stenoses in patients with severe atherosclerosis. Methods: 26 ICA's (7 without sten osis, 4 low-, 4 middle-, and 11 high-grade stenoses) in 13 patients were ex amined with DSA, CDUS, and 3D PDUS. CDUS and 3D PDUS were performed with a 7.5 MHz standard transducer and a Sonoline Elegra ultrasound machine. The t hree methods were performed and interpreted by different persons who were n ot aware of the diagnoses. Resuits: Regarding the degree of stenosis correl ations between DSA and 3D PDUS were r=0.98 (p<0.001), between DSA and CDUS r=0.97 (p<0.001), and between CDUS and 3D PDUS r=0.95 (p<0.001). Sensitivit y and specificity regarding the detection of a high-degree stenosis was 90% and 100% for 3D PDUS, and 100% and 93.3% for CDUS. Conclusion: Even in cas es with severe atherosclerosis, both sonographic methods reveal similar res ults comparable to DSA. 3D PDUS does not result in a diagnostic improvement on CDUS, however, it does give the new opportunity for complete data stora ge, reconstruction, and survey presentations.