Comparison of CT and ultrasonography in cervical carotid disease

ABSTRACT

Cervical CT identifies severe carotid stenasis >75%as commonly as Duplex ultrasonography, in addition, CT shows intraplaque pathology manifested by the lucent lesion, indicative of microhemorrahge or plaque necrosis. Lucent defects are not imaged by ultrasonography although complex echo patterns obtained with this method imply medial degeneration, a lesion that has been identified by some as being close to the plaque microhemorrhage. CT is clearly advantageous for showing intraplaque pathology. Both lesions, severe carotid stenosis and lucent defects are important plaque complications that correlate with appropriate symptoms of hemispheric ischemia and may serve as predictors of strake. Overall, the study indicates that cervical CT is at least comparable and possibly superior to carotid ultrasonography for the clinical investigation of complex cervical carotid plaques. Both methods used concurrently may obviete the need for the study of the cervical carotid with conventional angiography