Noninvasive methods in the diagnosis of extracranial carotid artery disease: a correlation with carotid arteriography in eighty patients.

Five hundred fifty-nine patients were evaluated for carotid artery disease in the Blood Flow Laboratory by the following direct and indirect noninvasive methods: 1. Periorbital doppler examination; 2. Ocular pneumoplethysmography (Gee); 3. Pulsed doppler ultrasonic arteriography; and 4. Sound spectral analysis with a pulsed doppler. Carotid arteriograms were available for comparison with one hundred fifty-seven vessels (80 patients). Sensitivity, specificity and overall accuracy was established for each noninvasive modality by correlation with the angiographic findings. For detection of stenoses greater than 50% by diameter reduction, sensitivity was 98%. Sound spectral analysis and ultrasonic arteriography were found to yield a higher sensitivity when compared to the other noninvasive methods in detecting stenoses of less than 50%. In our hands, disturbed spectral flow patterns do not always correlate with the degree of stenosis in non-hemodynamic lesions. Our results indicate that proper patient selection for angiographic examination can be made through noninvasive screening.