Comparison of continuous-wave Doppler imaging, oculopneumoplethysmography, and the cerebrovascular Doppler examination.

Previous reports of continuous-wave Doppler imaging have combined that technique with periorbital Doppler studies. In the present report, 75 patients with findings suggestive of cerebrovascular insufficiency were evaluated using continuous-wave Doppler imaging, oculopneumoplethysmography (OPG-G) and the cerebrovascular Doppler examination (CDE). Each test was interpreted independently. Doppler imaging had an overall accuracy of 85%, with a 68% accuracy in identifying 50-70% stenoses and a 69% accuracy in identifying high-grade stenoses (greater than 70%) and occlusion. OPG-G had an overall accuracy of 85%, with a 55% sensitivity for 50-70% stenoses and an 89% sensitivity for high-grade stenoses and occlusion. The CDE had an overall accuracy of 84% and a 50% sensitivity for stenoses of 50-70% and an 88% sensitivity for high-grade stenoses and occlusion. As an independent technique, continuous-wave Doppler imaging achieves an overall accuracy comparable to that of OPG-G or the CDE. Its sensitivity to high-grade stenosis and occlusion, however, is less than that of the other techniques. Since CDE and OPG-G had a 94% sensitivity to carotid occlusion and a combined sensitivity to high-grade stenoses and occlusion of 88% and 89%, respectively, their combined use with Doppler imaging offers sensitivity to and differentiation of stenoses from occlusion.