Research Article| Volume 25, ISSUE 6, P1355-1359, June 2016

Peak Systolic Velocity Measured by Continuous-Wave Doppler Ultrasonography without Angle Correction in Patients with Internal Carotid Artery Stenosis


      Peak systolic velocity (PSV) is measured with pulse-wave (PW) Doppler with angle correction in patients with internal carotid artery stenosis (ICAS). However, the correlation between conventional angiography and PSV shows considerable scattering. We hypothesized that measuring PSV without angle correction would lead to better inter-rater reliability. This hypothesis was tested using a sector probe and continuous-wave (CW) Doppler without angle correction.


      Consecutive patients with more than 50% ICAS were enrolled from a prospective database. PSV was measured with PW Doppler with angle correction (PW PSV) and CW Doppler without angle correction (CW PSV) by 2 examiners. The inter-rater reliabilities of PW PSV and CW PSV were analyzed by Spearman's rank correlation test.


      A total of 37 ICAS sites (median 67 [interquartile range 57-78] % stenosis) were enrolled. Measuring PSV using a sector probe insonating nearly parallel to the flow was feasible in all cases. Inter-rater reproducibility of CW PSV (Spearman's ρ = .810) was similar to that of PW PSV (Spearman's ρ = .796). When limited to patients with a PSV greater than 200 cm/s with both PW Doppler examinations (25 ICAS sites), inter-rater reliability was relatively higher for CW PSV (Spearman's ρ = .674) than for PW PSV (Spearman's ρ = .423).


      Measuring PSV with CW Doppler using a sector probe was feasible. Inter-rater reliability was similar between PW Doppler with angle correction and CW Doppler without angle correction in evaluating PSV in patients with ICAS. CW Doppler appears to have better inter-rater reproducibility than PW Doppler in assessing high PSV.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • The European Carotid Surgery Trialists Collaborative Group
        Risk of stroke in the distribution of an asymptomatic carotid artery.
        Lancet. 1995; 345: 209-212
        • Brott T.G.
        • Halperin J.L.
        • Abbara S.
        • et al.
        2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary: a report of the American College Of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Neurointerventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery.
        Vasc Med. 2011; 16: 35-77
        • von Reutern G.M.
        • Goertler M.W.
        • Bornstein N.M.
        • et al.
        Grading carotid stenosis using ultrasonic methods.
        Stroke. 2012; 43: 916-921
        • Latchaw R.E.
        • Alberts M.J.
        • Lev M.H.
        • et al.
        Recommendations for imaging of acute ischemic stroke: a scientific statement from the American Heart Association.
        Stroke. 2009; 40: 3646-3678
        • Phillips D.J.
        • Beach K.W.
        • Primozich J.
        • et al.
        Should results of ultrasound Doppler studies be reported in units of frequency or velocity?.
        Ultrasound Med Biol. 1989; 15: 205-212
        • Oh J.K.
        • Seward J.B.
        • Tajik A.J.
        Doppler echocardiography and color flow imaging: comprehensive noninvasive hemodynamic assessment.
        in: The echo manual. Lippincott Williams & Wilkins, Philadelphia2006: 59-79
        • Baumgartner H.
        • Hung J.
        • Bermejo J.
        • et al.
        Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice.
        J Am Soc Echocardiogr. 2009; 22 (quiz 101-102): 1-23
        • Tomii Y.
        • Toyoda K.
        • Suzuki R.
        • et al.
        Effects of 24-hour blood pressure and heart rate recorded with ambulatory blood pressure monitoring on recovery from acute ischemic stroke.
        Stroke. 2011; 42: 3511-3517
        • Koga M.
        • Kimura K.
        • Minematsu K.
        • et al.
        Diagnosis of internal carotid artery stenosis greater than 70% with power Doppler duplex sonography.
        AJNR Am J Neuroradiol. 2001; 22: 413-417