Carotid ultrasound criteria for detecting intracranial carotid stenosis

Eur Neurol. 2007;57(3):156-60. doi: 10.1159/000098467. Epub 2007 Jan 10.


Background/aims: This study attempted to establish carotid ultrasound criteria for identifying stenosis of the intracranial internal carotid artery (ICA) and middle cerebral artery (MCA).

Methods: Two hundred and fifty-five patients were enrolled. Ultrasound measurements for common carotid artery (CCA) and ICA were as follows: flow volume (FV), peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistance index (RI). The sensitivity and specificity of the ultrasound criteria for determining intracranial ICA or MCA>or=50% stenosis were calculated.

Results: The criteria identified for detecting intracranial ICA>or=50% stenosis were ICA FV<159 ml/min, ICA PSV<33 cm/s and CCA PSV<42 cm/s. When ICA PSV<33 cm/s was combined with CCA PSV<42 cm/s, sensitivity increased to 82%, with 91% specificity. The criteria identified for detecting MCA>or=50% stenosis were CCA FV<285 ml/min, ICA FV<179 ml/min, ICA PSV<33 cm/s, >35% reduction in FV in the CCA, >40% reduction in FV in ICA, and >35% reduction in PSV in ICA. When these criteria were combined, sensitivity increased to 69%, with 85% specificity.

Conclusion: This study demonstrated that ultrasound criteria are sensitive and specific for detecting intracranial ICA and MCA significant obstruction.

MeSH terms

  • Angiography / methods
  • Blood Flow Velocity
  • Carotid Artery, Internal / diagnostic imaging*
  • Carotid Stenosis / diagnostic imaging*
  • Humans
  • Middle Cerebral Artery / diagnostic imaging*
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity
  • Ultrasonography, Doppler, Duplex / methods*
  • Ultrasonography, Doppler, Duplex / standards*