Valoración no invasiva de la estenosis carotídea de causa aterosclerótica: Correlación entre la ecografía Doppler color y la angiografía por resonancia magnética con gadolinio

Abstract

Introduction: Carotid angiography is used to confirm carotid bifurcation (CB) stenosis. However, it is an invasive method that involves some morbidity. For this reason there is growing interest in non-invasive methods for the evaluation of carotid stenosis, including magnetic resonance angiography with gadolinium (MRAG) and color Doppler ultrasound (USDC). The aim of this study is to determine the correlation between the color Doppler ultrasound and magnetic resonance angiography with gadolinium in the evaluation of the degree of stenosis. Materials and methods: One hundred carotid bifurcations were studied by color Doppler ultrasound and magnetic resonance angiography with gadolinium between January 2009 and August 2011 in Sanatorio Allende. The level of agreement was determined using the Kappa coefficient, analyzing the percentage of carotid stenosis with color Doppler ultrasound according to the maximum systolic speed and the stenosis seen by magnetic resonance angiography with gadolinium, using the NASCET criteria for both methods. Results: An excellent correlation was obtained between Doppler ultrasound and magnetic resonance angiography with gadolinium, with a Kappa coefficient of 0.90 (95% CI: 0.786-0.99). There was disagreement between the two methods in assessing the plaque surface, showing that magnetic resonance angiography with gadolinium was better for detecting an irregular surface and / or ulcerated plaque. Conclusion: The technological improvement and the increase in reliable studies that have a good diagnostic correlation with non-invasive methods, it could be assumed that, in a short period of time, Doppler ultrasound will gradually replace angiography in the diagnosis of carotid pathology. © 2012 Sociedad Argentina de Radiología. Published by Elsevier Espan∼a, S.L. All rights reserved.