Three-dimensional ultrasonography for the evaluation of atherosclerotic stenoses of the carotid trunk

Three-dimensional ultrasonography is a significant novelty in neurosonology as it offers the possibility of an even more successful evaluation of atherosclerotic stenoses of the carotid trunk than previous ultrasonographic investigations. In 37 patients with signs of transitory ischemic attack and in 5 patients with reversible ischemic neurologic deficit we compared the findings of three-dimensional ultrasonography of carotid arteries on the neck with those of three-dimensional CT angiography. In 20 of these patients in which carotid thrombendarterectomy had been carried out, the findings of both diagnostic methods were also compared with the angiographic and operative findings. In 2 out of the total of 42 compared findings of three-dimensional ultrasonography, three-dimensional CT angiography and angiography of the carotid trunk, we assessed a difference in the evaluation of the degree of carotid stenosis while all other findings were in accordance as regards the evaluation of the degree of stenosis and plaque analysis. Of 20 operative findings, one showed insignificant deviations from the findings of both diagnostic methods. It is our opinion that three-dimensional ultrasonography is a reliable diagnostic method in evaluating atherosclerotic stenoses of carotid arteries. Every subtotal stenosis or internal carotid artery occlusion established by three-dimensional ultrasonography must be compared with three-dimensional CT angiography or classic angiography due to the objective possibility of false ultrasonographic interpretation and the significance of carotid thrombendarterectomy.