| Abstract [eng] |
Introduction Carotid stenosis is a luminal narrowing or total occlusion of the artery, which is caused by widespread systemic atherosclerotic disease in adult population. Carotid stenosis causes increased cerebrovascular risks, the most dangerous of such is cerebral infarction, which is the second cause of death and disability among adult population, therefore carotid stenosis grade diagnostics have a major prognostic and preventive value. Results Four main methods are currently in use for carotid stenosis evaluation, supported by grading criteria. The gold standard is considered to be a digital subtraction angiography, standardized by two systems of evaluation criteria, proven to have nearly perfect specificity, sensitivity and image resolution, however carrying a possibility of major long – term complication risks, requiring the use of contrast agents and exposure to X – ray radiation. Computed tomography angiography is a widely available diagnostics method, non - invasive, providing information about atherosclerotic plaque properties and having prospects for automatization, however, requiring use of contrast agents and X – rays. Different types of magnetic resonance angiography provide carotid stenosis assessment possibilities without using a contrast agent, intervention or X – ray exposure. Ultrasound is a safe and broadly available non – invasive imaging method, requiring no X – ray or contrast agent use. Most common types used are color – Doppler and Duplex ultrasound grading of stenosis is performed based on measuring and comparing blood flow velocities. Conclusions Digital subtraction angiography is considered a gold standard, exhibiting the best sensitivity and specificity. Ultrasound method is considered to be the least precise, according to research, published 15 – 40 years ago. The newest researches are demonstrating decreasing gap in specificity and sensitivity between digital subtraction angiography and other carotid stenosis evaluation methods. Results gathered by all four diagnostical methods statistically significantly correlate among themselves and have good or perfect agreement values. Different diagnostical methods demonstrate different precision evaluating different grades of stenosis. |
