ECG-gated blood-pool study of carotid arterial pulsation as a sign of stenosis: concise communication.

The large elastic arteries, such as the carotids, pulsate (expand and contract) in synchrony with the heart beat. These pulsations should be reduced by significant stenosis. This hypothesis was studied in 15 men by obtaining sequential ECG-gated labeled blood-pool images of these vessels in anterior and lateral oblique views. These were computer processed by a functional program that displays each pixel with an intensity proportional to its change in activity level during the cardiac cycle. Blank areas indicated lack of pulsation and were correlated with angiographic studies. The blank skip areas were present when there was 50% or greater narrowing in arterial diameter (94% sensitivity) but were not seen in patients with normal or minimally diseased vessels (25% or less narrowing). They were present inconsistently in the four vessels with 25 to 50% narrowing.