2004, Number 2
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ABSTRACTObjective. Determine the sensitivity and specificity of ultrasound, AngioCT and digital angiography in the diagnosis of carotid atherosclerotic disease.
Material and Method. Fifteen patients (30 carotid arteries) were evaluated, with a diagnosis of transient ischemic attack and/or cerebral infarction. Ultrasound was performed with a Hewlett Packard Image Point and a 7.5 MHz linear transducer. Angiotomography was performed with a helical Somatom Plus 4, Siemens, with 3 mm axial sections, 120 mL of I.V. contrast, with MPR, SSD, and MIP. Digital angiography was carried out with the Seldinger technique and ionic contrast. The results were analyzed according to the NASCET as mild (0- 29%), moderate (30-69%), severe (70- 99%) and obstruction.
Results. Ultrasonographically 22 presented stenosis (73.3%), 8 cases (36%) were mild, 9 cases (40.9%) moderate, 3 cases (13.6%) severe and obstruction in 2 (9%). Angiographically 12 (40%) stenosis cases were corroborated. AngioCT showed stenosis in 20 arteries (66.6%). Six cases were mild (30%), 7 (35%) moderate, 5 (25%) severe and 2 had obstruction (10%). These were corroborated in 50% with digital angiography. The sensitivity for US was 81%, for angioCT 100%, the specificities were 73% and 76%, respectively, the positive predictive value was 64% for both methods, and the negative predictive values were 87% and 100%, respectively.
Conclusion. Ultrasound is an effective method in cases of severe stenosis; angioCT is useful in the diagnosis of moderate and severe stenosis.
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