[Does cw Doppler ultrasound still have a value for cerebrovascular diagnosis today?]

The aim of this study was to assess the current value of extracranial continuous wave (cw) Doppler sonography in routine use as compared to color-coded duplex sonography. For this purpose, 500 carotid and 500 vertebral arteries were examined by a user experienced in both methods. The error rate of Doppler sonography was determined only when the methods allowed a clear decision to be made about the status of the vessel (normal findings including common variants, stenosis, and occlusion). In 85.4% of the carotid arteries and 88% of the vertebral arteries, the Doppler findings fulfilled the diagnostic differentiation unequivocally. For these cases, false findings were obtained in 1.9% of the carotid arteries and 0.2% of the vertebral arteries. Accordingly, a clear Doppler sonographic finding, normal or pathologic, is still of large diagnostic value. However, ambiguous or uncertain findings requiring further diagnostic workup are not uncommon. Thus, the sole use of cw Doppler sonography is no longer sufficient in a stroke center but still retains its utility in the practitioner's office.