Limitations of Doppler spectral broadening in the early detection of carotid artery disease due to the size of the sample volume.

In the present study the criteria of spectral broadening used in pulsed Doppler systems to diagnose minor disease in the cervical carotid arteries were evaluated in relation to the size of the sample volume. For this purpose the Doppler audio spectra as recorded in asymptomatic volunteers with an ATL Duplex scanner (relatively large sample volume) and a multi-gate pulsed Doppler system (relatively small sample volume) were compared with each other. The volunteers, randomly selected from the population registers, varied in age from 20-69 yr. Only in the common carotid artery at younger age, were normal spectra recorded, especially with the multi-gate system. In the internal carotid artery the number of spectra, supposed to be associated with low grade stenosis, increased significantly, especially when recorded with the Duplex scanner. More pronounced spectral broadening was found when the spectra were recorded distally in this artery. In the cervical carotid arteries normal spectra were found only when sampled in the middle of the bloodstream. These findings indicate that for the detection of vascular lesions in the cervical carotid arteries at an early stage of the disease on the basis of spectral broadening, small sample volumes and sampling in the centre of the vessel are required.