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Peer-reviewedCC BYCureus

Imaging Correlation of Color Doppler Ultrasound, CT Angiography, and MR Angiography Findings in Extracranial Carotid and Vertebral Artery Disease Among Ischemic Stroke Patients: A Prospective Observational Study.

6 affiliations
  1. 1Department of General Medicine, Medical and Surgical Services, Amrita Hospital, Faridabad, IND.
  2. 2Department of General Medicine, Dr. N. D. Desai Medical College & Hospital, Nadiad, IND.
  3. 3Department of General Medicine, Smt. B. K. Shah Medical Institute & Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, IND.
  4. 4Department of General Medicine, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, IND.
  5. 5Department of General Medicine, Manipal Hospital Yelahanka, Bengaluru, IND.
  6. 6Department of Respiratory Medicine, K S Hegde Medical Academy, Nitte University, Mangaluru, IND.

Abstract

Background and objective Extracranial carotid and vertebral artery (VA) atherosclerosis is an important contributor to ischemic stroke and recurrent cerebrovascular events. Color Doppler ultrasound is widely used as an accessible first-line modality, whereas CT angiography (CTA) and MR angiography (MRA) provide additional anatomical information regarding stenosis, plaque morphology, occlusion, and vascular variants. The objective of this study was to describe extracranial carotid and VA abnormalities in ischemic stroke patients using color Doppler ultrasound, CTA, and MRA and to assess aggregate distributional patterns of plaque characteristics and stenosis grades across these imaging modalities. Methods This prospective observational imaging correlation study included 50 patients with clinically suspected and neuroimaging-confirmed ischemic stroke who underwent extracranial vascular assessment. Demographic profile, vascular risk factors, Doppler plaque type, spectral broadening, CTA plaque morphology, MRA findings, and stenosis grades were analyzed. Additional descriptive and exploratory aggregate statistics included 95% CIs, chi-square tests for categorical distributions, aggregate modality-wise comparison of stenosis grades, and correlation of matched vessel-category stenosis percentages. Results The mean age was 63.6 ± 13.34 years (95% CI, 59.8-67.4), and 30 patients (60.0%) were male. Hypertension and smoking were the most frequent risk factors, each present in 27 patients (54.0%, 95% CI, 40.4-67.0), followed by diabetes mellitus in six patients (12.0%). The highest age-group burden was observed in the 61-70-year category (18/50, 36.0%; χ² = 13.00, p = 0.011). Doppler identified 76 plaque-positive vessel observations across eight evaluated vessel segments, with type II plaque being most frequent (32/76, 42.1%; p < 0.001). CTA plaque assessment showed an irregular plaque surface in 40/74 plaque observations (54.1%) and fatty or mixed plaques in 30/74 observations each (40.5%). Across five vessel segments and 250 vessel observations per modality, clinically significant stenosis (≥50% stenosis or occlusion) was noted in 14 observations (5.6%) by Doppler, 14 (5.6%) by CTA, and 18 (7.2%) by MRA; the aggregate between-modality difference was not statistically significant (χ² = 0.74, p = 0.690). Matched vessel-category stenosis percentages showed very strong aggregate correlations between Doppler and CTA (Pearson r = 0.981), Doppler and MRA (r = 0.988), and CTA and MRA (r = 0.970; all p < 0.001). Conclusions Color Doppler ultrasound demonstrated useful screening capability for extracranial carotid disease in ischemic stroke patients, while CTA and MRA added anatomical clarification of plaque morphology, stenosis, occlusion, and vertebrobasilar variants. The stenosis-grade distribution appeared comparable across modalities at an aggregate level; however, patient-level agreement, diagnostic accuracy measures, and outcome correlation could not be established without larger datasets containing paired raw imaging results and standardized reference criteria.

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BibTeX
@article{singh2026imaging,
  title = {{Imaging Correlation of Color Doppler Ultrasound, CT Angiography, and MR Angiography Findings in Extracranial Carotid and Vertebral Artery Disease Among Ischemic Stroke Patients: A Prospective Observational Study.}},
  author = {Rashmi Singh and Mansi Patel and Kiran Katara and Sangeetha Panneerselvam and Anvitha Rose George and Nidhi Sai Sunil},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116627},
  url = {https://europepmc.org/article/MED/42909894},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Imaging Correlation of Color Doppler Ultrasound, CT Angiography, and MR Angiography Findings in Extracranial Carotid and Vertebral Artery Disease Among Ischemic Stroke Patients: A Prospective Observational Study.
AU  - Rashmi Singh
AU  - Mansi Patel
AU  - Kiran Katara
AU  - Sangeetha Panneerselvam
AU  - Anvitha Rose George
AU  - Nidhi Sai Sunil
PY  - 2026
DA  - 2026/09/21
JO  - Cureus
DO  - 10.7759/cureus.116627
UR  - https://europepmc.org/article/MED/42909894
AB  - Background and objective Extracranial carotid and vertebral artery (VA) atherosclerosis is an important contributor to ischemic stroke and recurrent cerebrovascular events. Color Doppler ultrasound is widely used as an accessible first-line modality, whereas CT angiography (CTA) and MR angiography (MRA) provide additional anatomical information regarding stenosis, plaque morphology, occlusion, and vascular variants. The objective of this study was to describe extracranial carotid and VA abnormalities in ischemic stroke patients using color Doppler ultrasound, CTA, and MRA and to assess aggregate distributional patterns of plaque characteristics and stenosis grades across these imaging modalities. Methods This prospective observational imaging correlation study included 50 patients with clinically suspected and neuroimaging-confirmed ischemic stroke who underwent extracranial vascular assessment. Demographic profile, vascular risk factors, Doppler plaque type, spectral broadening, CTA plaque morphology, MRA findings, and stenosis grades were analyzed. Additional descriptive and exploratory aggregate statistics included 95% CIs, chi-square tests for categorical distributions, aggregate modality-wise comparison of stenosis grades, and correlation of matched vessel-category stenosis percentages. Results The mean age was 63.6 ± 13.34 years (95% CI, 59.8-67.4), and 30 patients (60.0%) were male. Hypertension and smoking were the most frequent risk factors, each present in 27 patients (54.0%, 95% CI, 40.4-67.0), followed by diabetes mellitus in six patients (12.0%). The highest age-group burden was observed in the 61-70-year category (18/50, 36.0%; χ² = 13.00, p = 0.011). Doppler identified 76 plaque-positive vessel observations across eight evaluated vessel segments, with type II plaque being most frequent (32/76, 42.1%; p < 0.001). CTA plaque assessment showed an irregular plaque surface in 40/74 plaque observations (54.1%) and fatty or mixed plaques in 30/74 observations each (40.5%). Across five vessel segments and 250 vessel observations per modality, clinically significant stenosis (≥50% stenosis or occlusion) was noted in 14 observations (5.6%) by Doppler, 14 (5.6%) by CTA, and 18 (7.2%) by MRA; the aggregate between-modality difference was not statistically significant (χ² = 0.74, p = 0.690). Matched vessel-category stenosis percentages showed very strong aggregate correlations between Doppler and CTA (Pearson r = 0.981), Doppler and MRA (r = 0.988), and CTA and MRA (r = 0.970; all p < 0.001). Conclusions Color Doppler ultrasound demonstrated useful screening capability for extracranial carotid disease in ischemic stroke patients, while CTA and MRA added anatomical clarification of plaque morphology, stenosis, occlusion, and vertebrobasilar variants. The stenosis-grade distribution appeared comparable across modalities at an aggregate level; however, patient-level agreement, diagnostic accuracy measures, and outcome correlation could not be established without larger datasets containing paired raw imaging results and standardized reference criteria.
SN  - 2168-8184
ER  -