Background and purpose:–In past few decades it has been observed that there is continous rise in cases of stroke, majority of  strokesare associated with carotid stenosis in patients specially in elderly age group or having various risk factors such as smoking, hypertension, diabetes mellitus and dyslipidemia. Due to technological development in various non invasive modalities requires assesment of reliability, sensitivity, specificity and accuracy in comparisionwith DSA. Early detection of stenosis and grading may help physician for planning further treatment and management and hence decrease in mortality and morbidity to the patients. We evaluated role of Doppler USG, MRA in comparision with DSA for detection of carotid artery stenosis. 

Material and methods:–In our prospective study of 50 patients wereassessed of all age groups in male and female. We compared all risk factors associated with stenosis and grading of stenosis with USG Doppler, MRA and DSA was done. PSV and ICA/CCA ratios were obtained for all cases which showed to have linear relation with degree of stenosis.

Results:– Overall sensitivity, specificity and diagnostic accuracy of USG was 91.49%,93.34%, 93% while MRA showed sensitivity, specificity and diagnostic accuracy of 95.12%, 94.34%, 98% respectively. DSA had sensitivity, specificity and diagnostic accuracy of 100%. Combined Sensitivity, specificity, diagnostic accuracy of both MRA and USG Doppler was 97%, 95% and 96% respectively.

Conclusion:–USG and MRA combined gives near equal sensitivity in detection of lesion and lesion characterisation becomes modaliy of diagnosis and DSA remain gold standard for diagnosis in cases of dilemma and therapeutic approach.