Comparison of digital subtraction angiography and contrast-enhanced ultrasound in assessment of carotid stenosis

Abstract

Introduction: The performances of contrast-enhanced ultrasound (CEUS) and digital subtraction angiography (DSA) were used to establish an efficient as well as non-invasive clinical technique for the diagnosis of extra-cranial internal carotid artery (ICA) stenosis. Materials and methods: Thirty-six successive patients (11 women and 25 men, mean age: 65.0 ± 9.2, range: 43–78 years) with internal carotid artery (ICA) stenosis were tested by CEUS and DSA. These tests were carried out by means of Hitachi Preirus ultrasound machine for CEUS and Allura Xper FD20 system (Philips Medical Systems, Nederland B.V.) for DSA. 1.2 ml Son- oVue (Bracco, Switzerland) was used a s contrast agent. Results: The results clearly indicated that there were no noteworthy variations among the distributions recorded by CEUS as well as DSA for the four tested groups. The percentage of diameter stenosis calculated by CEUS was clearly in accordance with the DSA images. CEUS showed accurate results with good specificity and sensitivity at 50%, 70%, and 100%. Also, CEUS per- formance was relatively better than DSA in the diagnosis of ICA and suitability of CEA. Conclusion: CEUS proved to be a precise non-invasive testing method for the diagnosis of carotid artery stenosis which is more feasible and well-tolerated in patients with various stages of carotid stenosis. Keywords: Carotid artery stenosis; CEUS; contrast-enhanced ultrasound; digital subtraction angiography.