Diagnostic Accuracy of Duplex Ultrasonography Versus Computed Tomographic Angiography in the Detection of Significant Carotid Artery Atherosclerosis

Objective: To determine the diagnostic accuracy Duplex of Ultrasonography in detecting clinically significant carotid atherosclerosis by keeping Computed Tomographic Angiography as a gold standard. Study Design: Cross-Sectional study Place and Duration of Study: Armed Forces Institute of Radiology and Imaging Rawalpindi Pakistan, from Jun to Nov 2019. Methodology: All patients referred with neurological symptoms during the study were included. Duplex (Doppler) ultrasound and Computed Tomographic Angiography of bilateral carotid arteries were performed on all these patients. The percentage of carotid stenosis was calculated for both modalities. Data was recorded separately for both right and left carotid arteries. Results: Out of 170 carotid arteries in 85 patients, Duplex ultrasound supported the diagnosis of clinically significant carotid atherosclerosis in 89 arteries (52.3%), and CTA confirmed it in 86 arteries (50.5%). Overall, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Duplex ultrasonography in the detection of clinically significant carotid atherosclerosis by taking computed tomographic angiography (CTA) as a gold standard was 92.0%, 89.0%, 89.8%, 92.5% and 91.1% respectively Conclusion: Duplex ultrasonography is an accurate, non-invasive imaging investigation for detecting carotid atherosclerosis.