The panel also considered various technical aspects of carotid US and methods for quality assessment, and identified several important unanswered questions meriting future research. Measuring PSV is the most important component of the carotid Doppler examination. Paired PSV and NASCET values for the 977 stenoses have been derived. 20 24 The plot shows median PSV, 25 to 75 (boxes), and 0 to 100 interquartile range (T-bars), except outliers (circles) and extreme values (stars). The conclusion should state an estimated degree of ICA stenosis as reflected in these categories. Normal <50 50-69 70butlessthan nearocclusion Nearocclusion Totalocclusion (cm/sec) <125 <125 125-230 230 High,lowor undetectable Undetectable () None <50 50 50 Visible Visible,no detectablelumenRatio <2.0 <2.0 2.0-4.0 4. Box plot chart of peak systolic velocity (PSV cm/s) vs NASCET degree of stenosis () for 977 stenoses from 5 studies. Study limitations should be noted when they exist. The optimal peak systolic velocity thresholds for stenosis in stented carotid arteries were higher than those for native carotid arteries. Fifth, the final report should discuss velocity measurements and grayscale and color Doppler findings. Fourth, ICA should be diagnosed as normal when ICA PSV is less than 125 cm/second and no plaque or intimal thickening is visible, less than 50% stenosis when ICA PSV is less than 125 cm/second and plaque or intimal thickening is visible, 50 to 69% stenosis when ICA PSV is 125 to 230 cm/second and plaque is visible, > or =70% stenosis to near occlusion when ICA PSV is more than 230 cm/second and visible plaque and lumen narrowing are seen, near occlusion when there is a markedly narrowed lumen on color Doppler US, and total occlusion when there is no detectable patent lumen on grayscale US and no flow on spectral, power, and color Doppler US. Two additional parameters (the ICA-to-common carotid artery PSV ratio and ICA end diastolic velocity) may also be used when clinical or technical factors raise concern that ICA PSV may not be representative of the extent of disease. Third, ICA peak systolic velocity (PSV) and the presence of plaque on grayscale and/or color Doppler images are primarily used in the diagnosis and grading of ICA stenosis. Following the stenosis the turbulent flow may swirl in both directions. This is evident by the wide range of velocity parameters reported in the literature, with PSV threshold between 150 cm/s and 250 cm/s to predict >50 CCA. Second, the degree of stenosis determined at grayscale and Doppler US should be stratified into the categories of normal (no stenosis), less than 50% stenosis, 50 to 69% stenosis, > or =70% stenosis to near occlusion, near occlusion, and total occlusion. All the subjects underwent duplex colour doppler scanning of their Common Carotid Artery (CCA) Internal Carotid Ar- tery (ICA) and Vertebral Arteries (VA) on. Elevated peak systolic velocity at the stenosis with pansystolic spectral broadening. 16-49 stenosis: pansystolic spectral broadening with a PSV <125 cm/s. Key elements of the statement include the following: First, all internal carotid artery (ICA) examinations should be performed with grayscale, color Doppler, and spectral Doppler US. deceleration spectral broadening with a peak systolic velocity (PSV) <125 cm/s. The panel's consensus statement is believed to represent a reasonable position on the basis of analysis of available literature and panelists' experience. This study proposed the incorporation of distal ICA flow velocity information on the conventional carotid Doppler study improving the diagnostic accuracy of PSV 1.The Society of Radiologists in Ultrasound convened a multidisciplinary panel of experts in the field of vascular ultrasonography (US) to come to a consensus regarding Doppler US for assistance in the diagnosis of carotid artery stenosis. There may be compensatory increased velocity in the contralateral carotid No detectable patent lumen at gray-scale US and no flow with spectral, power, and colour Doppler ultrasound. Velocity parameters may not apply, since velocities may be high, low, or undetectableĭiagnosis is established primarily by demonstrating a markedly narrowed lumen at colour or power Doppler ultrasound Society of Radiologists in Ultrasound (SRU) consensusĪCI PSV /= 70% ICA stenosis but less than near occlusion:ĪCI PSV is >230 cm/sec and visible plaque and luminal narrowing are seen at gray-scale and colour Doppler ultrasoundĪdditional criteria include ACI/ACC PSV ratio >4 and ACI EDV >100 cm/sec
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