# Comparative Evaluation of Doppler Sonography and Magnetic Resonance Angiography in Assessing Extracranial Carotid and Vertebral Arteries in Patients With Stroke

## TL;DR

This study compares Doppler sonography and MRA for detecting vascular issues in stroke patients, finding both useful but with MRA offering better detail.

## Contribution

The study provides a comparative evaluation of Doppler sonography and MRA for extracranial artery assessment in stroke patients.

## Key findings

- Doppler sonography reliably detects occlusive disease in stroke patients.
- MRA provides superior resolution for high-grade stenosis and collateral circulation.
- Combined use of both modalities enhances diagnostic accuracy and therapeutic decision-making.

## Abstract

Objective: This study aimed to evaluate the performance of Doppler sonography in identifying extracranial vascular abnormalities in patients with stroke and to compare its findings with those obtained from magnetic resonance angiography (MRA).

Methodology: This observational study included 150 patients with stroke or transient ischemic attack (TIA) who presented to Shri B.M. Patil Medical College between November 2019 and September 2022. All patients underwent color Doppler ultrasonography using a Philips HD-11 XE machine (Koninklijke Philips N.V., Amsterdam, Netherlands) with a 4-11 MHz linear probe to evaluate the carotid and vertebral arteries for stenosis, plaque formation, and flow irregularities. MRA was performed on a GE 1.5 Tesla SIGNA MRI scanner (GE Healthcare, IL, USA) using 3D time-of-flight (TOF) and gadolinium-enhanced sequences. Imaging findings from both modalities were compared using paired proportion statistical analysis.

Results: The mean age of participants was 60.66 ± 10.91 years, comprising 126 males (84%) and 24 females (16%). The internal carotid artery (ICA) and vertebral artery were the most frequently affected vessels, demonstrating abnormalities in 84 (56%) and 78 (52%) cases, respectively, on both Doppler and MRA. Bulb involvement was observed in 21 (14%) cases on Doppler and 15 (10%) on MRA. Collateral formation was most frequently noted on MRA in the vertebral artery (51 (34%)) and ICA (45 (30%)), whereas Doppler detected none. Complete occlusion and thrombosis were each most commonly observed in the ICA and vertebral arteries (78 (52%) cases).

Conclusions: Doppler sonography is a reliable bedside screening tool for detecting significant occlusive disease in patients with stroke. However, MRA offers superior resolution, particularly for assessing high-grade stenosis and collateral circulation. Together, they serve as complementary diagnostic modalities, and their combined use may enhance stroke evaluation and support more effective therapeutic decision-making.