Comparative diagnostic value of carotid colour Doppler ultrasound and carotid magnetic resonance angiography in detecting carotid artery stenosis.

Abstract

Aim: To compare the diagnostic value of carotid colour Doppler ultrasound (CDO) and magnetic resonance angiography (MRA) in detecting carotid vascular stenosis, using digital subtraction angiography (DSA) as the gold standard.

Materials and methods: A total of 120 patients admitted between January 2022 and December 2024 were divided into two groups of 60 based on the initial imaging modality. The CDO group underwent carotid CDO followed by DSA for suspected stenosis, while the MRA group received MRA first, with DSA performed for confirmed cases. DSA served as the reference standard. Stenosis severity was graded using NASCET criteria, and sensitivity, specificity, accuracy and agreement (Kappa) with DSA were calculated.

Results: CDO showed excellent agreement with DSA (Kappa = 0.823), with 97.67% sensitivity, 88.24% specificity and 95.00% accuracy, demonstrating high consistency across all stenosis grades and occlusion. MRA showed moderate agreement with DSA (Kappa = 0.657), achieving 97.30% sensitivity, 65.22% specificity and 85.00% accuracy, with notable overestimation in mild stenosis.

Conclusion: Both CDO and MRA are valuable non-invasive tools for evaluating carotid vascular stenosis. CDO is simple, cost-effective and suitable for large-scale screening, whereas MRA provides detailed vascular anatomy and is better suited for confirmatory assessment of complex lesions. Appropriate selection or combined use can improve diagnostic accuracy and clinical decision-making.