COMPARISON OF CAROTID DOPPLER ULTRASOUND AND COMPUTERIZED TOMOGRAPHIC ANGIOGRAPHY IN THE EVALUATION OF CAROTID ARTERY STENOSIS: A SYSTEMIC REVIEW AND META-ANALYSIS

Introduction: Accurate non-invasive carotid imaging is important for effective secondary stroke prevention. We conducted a systematic review and meta-analysis to compare DUS and CTA accuracy for diagnosing (70-99%) carotid artery stenosis. Methodology: A systematic search was conducted in PubMed and Embase from February, 2021, to March, 2021, to compare diagnostic test accuracy of DUS and CTA. The stated method for determining the degree of stenosis (e.g., NASCET or ECST) Results: In 23 included studies with 3229 participants, the pooled sensitivity for CTA test is 0.79 [0.72, 0.85], and the pooled specificity is 0.93 [0.84, 0.97]. We also found that the pooled sensitivity for DUS test is 0.90 [0.80, 0.95], and the pooled specificity is 0.87 [0.75, 0.94]. Regarding the CTA test, most of the points gathered around the top left of the graph, with the area under the curve of 0.87 [0.84-0.90], indicate the test's good accuracy. For the DUS test, most of the points clustered around the top left of the graph, with area under the curve of 0.95 [0.92-0.95], indicating high accuracy of the test. Conclusion: We found relatively high sensitivity and specificity of both CTA and DUS tests. However, the DUS test's accuracy in diagnosing (70-99%) carotid artery stenosis was greater than CTA.