Abstract 19604: Real-time Three-dimensional Ultrasound Accurately Diagnoses and Stages Carotid Occlusive Disease
Introduction: Real-time three-dimensional ultrasound (rt-3DUS) is a novel imaging technology that has not been reported in the evaluation of carotid artery occlusive disease. Like duplex ultrasound, this technique is noninvasive, carries no risk to the patient, and has no contraindications. Unlike duplex, it immediately and automatically provides accurate 3D imaging of carotid anatomy. By direct comparison to duplex, we sought to validate the diagnostic accuracy of rt-3DUS.
Methods: Duplex and rt-3DUS were performed in patients with known carotid occlusive disease. Transcutaneous rt-3DUS was performed from the neck using a 7-2 MHz hand-held transducer and associated Philips iE-33 platform. 3D data sets were exported to a Tomtec workstation for 3D model reconstruction (figure) and measurement of linear and cross sectional area (XSA) stenosis by NASCET criteria. Rt-3DUS values were then compared to duplex values.
Results: 30 internal carotid arteries (ICA) were studied: 13/30 (43%) had >70% stenosis, 9/30 (30%) had 50–69% stenosis, and 8/30 (27%) had 16–49% stenosis by duplex. Utilizing NASCET criteria to evaluate % ICA stenosis by rt-3DUS, 12/30 (40%) had >70%, 9/30 (30%) had 50–69%, and 9/30 (30%) had 16–49% stenosis. Percent linear and percent XSA stenosis by rt-3DUS correlated with percent stenosis by duplex, with correlation coefficients of R=0.90 and R=0.92, respectively. The inverse of peak systolic velocity by duplex also correlated to percent XSA stenosis on rt-3DUS, with R=0.90.
Conclusions: These results validate rt-3DUS as a novel imaging technology that not only accurately diagnoses and stages carotid occlusive disease, but also provides a 3D model of the carotid bifurcation. This technique provides a new approach to obtaining 3D carotid anatomic imaging without the radiation exposure or iodinated contrast administration required by current cross sectional imaging modalities.
- © 2010 by American Heart Association, Inc.