Noninvasive diagnosis of extracranial carotid arterial disease: a prospective evaluation of pulsed-Doppler imaging and oculoplethysmography.

Two hundred consecutive internal carotid arteries were examined with the Hokanson-pulsed Doppler ultrasonic arteriograph (UA) and the Kartchner-McCrae oculoplethysmograph (OPG). Roentgenographic studies were used to assess the relative accuracy of these two noninvasive tests. Diameter stenoses estimated from the UA and roentgenographic images agreed within +/- 20% in 81% of the studies. The UA detected 61% of all stenoses of 20% to 39% and 89% of all stenoses greater than 40%. A sensitivity of 86% and a specificity of 90% were achieved with the UA compared with a sensitivity of 64% and a specificity of 85% with the OPG. When the UA and OPG agreed (67% of the vessels), the sensitivity was 95% and the specificity was 94%. When they disagreed, the UA was the better test having a sensitivity of 81% compared with 21% with the OPG.