Original Paper

Duplex Scanning Diagnosis of Internal Carotid Artery Dissections
A Case Control Study
C. Alecu^a, J.O. Fortrat^b, X. Ducrocq^a, H. Vespignani^a, J.M. de Bray<sup>c

a</sup>Neurology Department, University Hospital, Nancy,
^bCNRS 6214 Inserm 771, and
^cNeurology Department, University Hospital, Angers, France

Address of Corresponding Author

Cerebrovasc Dis 2007;23:441-447 (DOI: 10.1159/000101469)

  Key Words

• Dissection
• Ultrasound
• Acute stroke

  Abstract

Background: The reliability of duplex scanning (DS) for the diagnosis of internal carotid artery dissections (ICAD) is not clear. Methods: Nine DS signs known to be suggestive for the diagnosis of ICAD were compared between 70 patients with ICAD and 70 matched patients without dissection. Results: Visible internal tapering occlusion, regular eccentric narrowing channel, ectasia beyond the carotid bulb, resistive index asymmetry, blood flow slowdown, ophthalmic artery blood flow inversion, and biphasic flow are more frequent in cases than in controls (p < 0.001). Atheroma plaques were absent in 80% of ICAD. When DS direct signs and hemodynamic signs were studied, sensitivity was 90% and specificity 60%. Conclusion: Diagnosis of ICAD by DS could be improved if direct signs were combined with hemodynamic signs, giving a high sensitivity and a rather good specificity.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Cosmin Alecu
Neurology Department, University Hospital
FR-54039 Nancy (France)
Tel. +33 3 83 85 16 86, Fax +33 3 83 85 11 59
E-Mail c.alecu@chu-nancy.fr

  Article Information

Received: June 19, 2006
Accepted: December 8, 2006
Published online: April 2, 2007
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 3, Number of References : 25