Evaluation of Carotid Artery Doppler & Its Correlation with Non-Contrast Computed Tomography Head in Ischemic Stroke Patients

Abstract

Introduction: Ischemic stroke is a major cause of mortality and long-term neurological disability. Carotid atherosclerosis is an important and potentially treatable contributor, while non-contrast computed tomography (NCCT) demonstrates cerebral ischemic injury. Combined assessment may improve etiological evaluation, vascular characterization, and risk stratification in affected patients.

Aim & Objective: The study aimed to assess the correlation between carotid artery Doppler and non-contrast CT findings in ischemic stroke, identify commonly involved vascular territories, and evaluate major risk factors for carotid artery stenosis.

Materials & Methods: This prospective study was conducted in the Department of Radiodiagnosis, G.R. Medical College, Gwalior, Madhya Pradesh, among 96 clinically suspected stroke patients with ischemic stroke on CT. Patients with head injury, space-occupying lesions, demyelinating disorders, stroke mimics, or refusal of consent were excluded. Carotid Doppler parameters, plaque characteristics, stenosis severity, vascular territories, and NCCT findings were analyzed and correlated statistically.

Results: Mean age was 60.91 ± 8.32 years; 56.3% were males. Carotid stenosis was detected in 74.0%, most commonly <50% stenosis (47.9%), while complete occlusion occurred in 2.1%. Echogenic plaque was most frequent (34.38%). Right and left ICA peak systolic velocities and bilateral ICA/CCA ratios were significantly higher in stenosis. MCA territory predominated, with right MCA infarction in 22.9% and left MCA in 20.8%. Hypertension, diabetes, smoking, and hyperlipidemia were significantly associated with stenosis. ASPECTS correlated inversely with stenosis percentage (r=-0.764) and ICA Doppler parameters.

Conclusion: Carotid Doppler and NCCT are complementary modalities for evaluating ischemic stroke. Increasing carotid stenosis is associated with greater cerebral ischemic burden, supporting combined imaging for diagnosis, vascular risk assessment, risk stratification, clinical management and secondary prevention.

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