[Ultrasonic study of the carotid artery bifurcation. Comparative study with arteriography (50 cases)]

This prospective study was initiated in March 1981 and all results were compared with arteriography. The investigations were carried out with a real time Toshiba SAL 20 equipped with a 5 MHz transducer and a DUD 400 continuous Doppler ultrasonogram with a 4 MHz transducer. All patients were referred to us from the neurological and cardiac departments of our hospital. They had a wide range of conditions varying from simple paraesthesia to massive hemiplegia or from arrhythmias to syncope. The investigation always started with classical Doppler examination (12 recording points) and was followed by real time ultrasonography of the cervical vascular axes. An improved diagnostic performance with the association of Doppler + real time B mode ultrasonography was demonstrated in a previous study. The results of this study were compared with the angiographic appearances and a close correlation was observed with normal and pathological cases. In this series of 50 cases the sensitivity was 92 p. 100 and the specificity 87 p. 100. More detailed analysis of this population showed the two false negatives to correspond to two ulcerated atheromatous plaques at the carotid bifurcation. The false positive results were more difficult to interpret and may have been due to technical artefacts. However, other workers have already encountered this difficulty with surgery demonstrating the plaques detected by ultrasound. In conclusion, real time ultrasonography and Doppler are two complementary investigations which when used by the same operator can become very sensitive and reliable methods of investigation.(ABSTRACT TRUNCATED AT 250 WORDS)