Interdisciplinary Neurosurgery (Sep 2021)
Retrospective analysis of two diagnostic tests: Carotid Doppler ultrasound and diagnostic cerebral angiography for carotid disease in the Mexican population
Abstract
Objective: To know the clinical presentation and affected vessels as well as evaluate the carotid Doppler ultrasound (CDU) vs. diagnostic cerebral angiography (DCA) both due to the percentage of significant stenosis (>50%), and the presence of carotid ulcers in Mexican population. Patients and Methods: In Mexico City, from January 2018 to January 2020, was realized a retrospective analysis in a third-level hospital, which qualitative variables were studied. In the case of the percentage of stenosis, the existence -or not- of significant stenosis was considered. The sensitivity, specificity, negative predictive value and positive predictive value of ultrasound vs. angiography for significant stenosis and for the detection of ulcers was also calculated. Results: A total of 30 patients were analyzed, 18 men and 12 women with an age range between 47 and 89 years and an average age of 71 years. The arterial locations most frequently reported by ultrasound and angiography were graphed, as well as the mean percentage of stenosis. Regarding the evaluation of the Doppler ultrasound as a diagnostic test, 78% of sensitivity and a 53% of specificity for the percentage of stenosis, so it was greater than or equal to 50%; and a sensitivity of 0% and specificity of 90% for the detection of ulcers. Conclusions: The value of ultrasound as a diagnostic test compared to gold standard, contrasts with the result that was reported in the reading. We consider that the intentional search for carotid ulcers in patients who have already presented medical history compatible with carotid disease should be more exhaustive, based on studies with greater sensitivity, although they could be more invasive or more expensive.
