Assessment of directional Doppler ultrasound techniques in the diagnosis of carotid artery diseases.

Abstract

The aetiology of transient cerebral ischaemia is complex. For these reasons the development of non-invasive techniques that can detect lesions in the vessels supplying the affected cerebral hemisphere has been pursued. These include ophthalmodynamometry (Liversedge and Smith, 1961), thermography (Wood, 1965), carotid phonoangiography (Duncan et al., 1975), ocular plethysmography (Gee et al., 1974), and radioisotope cerebral perfusion (Weissman et al., 1975).

Clinical diagnosis by transcutaneous Doppler ultrasound

“…Both pulsed and continuous wave systems have been shown to be capable also of imaging arterial walls and lumen (Mozersky et al, 1971;Barnes et al, 1976a;Lewis et al, 1978a) (Thompson and Talkington, 1976 The direction of supraorbital arterial flow has been used by several workers to assess extracranial arterial disease (Muller, 1971;Lye, Sumner and Strandness, 1976;Prichard, Martin and Sheriff, 1979). Consecutive compression of a number of arteries in the head and neck allow deduction of the site of obstruction.…”

“…Of the three, the Doppler examination emerged as the most versatile, portable, convenient and the least expensive. If, in addition to the direction of flow in the supraorbital artery, the flow wave shape is also analysed and compared with findings in the common carotid artery (Baskett et al, 1977;Prichard et al, 1979) then diagnostic information may be obtained from the amplitude ratio between the two vessels during systole. It was also pointed out by Prichard et al (1979) that the use of direct percutaneous carotid angiography and arch aortography to identify occlusive carotid artery disease may lead to major (1%) or minor (14%) complications that are not encountered when transcutaneous Doppler ultrasound is used.…”

“…If, in addition to the direction of flow in the supraorbital artery, the flow wave shape is also analysed and compared with findings in the common carotid artery (Baskett et al, 1977;Prichard et al, 1979) then diagnostic information may be obtained from the amplitude ratio between the two vessels during systole. It was also pointed out by Prichard et al (1979) that the use of direct percutaneous carotid angiography and arch aortography to identify occlusive carotid artery disease may lead to major (1%) or minor (14%) complications that are not encountered when transcutaneous Doppler ultrasound is used. Further, Crummy et al (1979) found good agreement in the evaluation of carotid obstruction between transcutaneous Doppler ultrasound studies of ophthalmic artery flow and direct carotid arterial imaging, while Otis et al (1979) and HodekDemarin and Muller (1979) have discussed possible pitfalls in assessing some patients with carotid occlusion.…”

Evaluation of Blood Velocity Waveform Features in Common Carotid Artery for Healthy Subjects and Cardiovascular Patients

“…Numerous studies had presented that spectral analysis of Doppler signal and blood flow waveform in blood vessel changes with vascular disease [3]. These analyses are extremely powerful non-invasive tool for clinical diagnosis such as in the artery disease.…”

Erythrocyte Flow Velocity Changes with Age and Sex in Augmented Supraorbital, Superficial Temporal and Common Carotid Pulses

“…Spectral anal ysis of Doppler signals has increased the ac curacy of ultrasound for detection of occlu sive disease at the carotid bifurcation [Bas kett et al, 1977;Prichard et al, 1979]. In these studies sonagrams were assessed from resting supraorbital or supratrochlear pulses and from common carotid pulses.…”