Comparison of color-flow Doppler scanning, power Doppler scanning, and frequency shift for assessment of carotid artery stenosis

被引:45
作者
Müller, M
Ciccotti, P
Reiche, W
Hagen, T
机构
[1] Univ Hosp Saarland, Dept Neurol, D-66421 Homburg, Germany
[2] Univ Hosp Saarland, Dept Neuroradiol, D-66421 Homburg, Germany
关键词
D O I
10.1067/mva.2001.118581
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: We investigated the accuracy of color-flow Doppler (CD) scanning, power Doppler (PD) scanning, and peak systolic Doppler frequency shift (PSF) in assessment of carotid artery stenosis with angiography used as gold standard, including the measurement techniques used in the North American Symptomatic Carotid Surgery Trial (NASCET) and the European Carotid Surgery Trial (ECST). Methods. Fifty-eight consecutive patients diagnosed for carotid artery surgery underwent color-coded duplex sonography and angiography. The duplex examination included the assessment of PSF and the videotaping of sagittal images in CD and PD mode from the proximal common carotid artery to the distal internal carotid artery. Two experienced examiners performed the studies, but once one examiner had done the taping, the other examiner was allowed only to review the tape. Separately, each examiner reviewed the tapes and determined by cursor settings each stenosis according to NASCET and ECST. For interobserver agreement kappa statistic was used. To compare with angiography (degree of stenosis 40%, 50%, 60%, 70%, and 80%) sensitivity, specificity, positive and negative predictive values, and overall accuracy were calculated. PSF cut-off frequencies were based on receiver operator curve analysis. Results. Because interobserver agreement in CD and PD was good (chance-corrected kappa > 0.6), further analysis used the between-observer mean value for each stenosis. With the NASCET measurement technique, accuracy of Doppler techniques to distinguish a 50% stenosis was 89% for PSF, 91% for CD, and 93% for PD; for a 70% stenosis it was 83% for PSF, 84% for CD, and 81% for PD. With the ECST measurement technique, accuracy to distinguish a 70% stenosis was 86% for PSF, 88% for CD, and 86% for PD; for an 80% stenosis it was 87% for PSF, 87% for CD, and 77% for PD, Conclusion: CD and PD carotid artery stenosis measurements are highly reproducible, and in our hands provided accuracy equal to PSF.
引用
收藏
页码:1090 / 1095
页数:6
相关论文
共 20 条
[1]   Grading carotid stenosis with ultrasound - An interlaboratory comparison [J].
Alexandrov, AV ;
Vital, D ;
Brodie, DS ;
Hamilton, P ;
Grotta, JC .
STROKE, 1997, 28 (06) :1208-1210
[2]   Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis [J].
Barnett, HJM ;
Taylor, W ;
Eliasziw, M ;
Fox, AJ ;
Ferguson, GG ;
Haynes, RB ;
Rankin, RN ;
Clagett, GP ;
Hachinski, VC ;
Sackett, DL ;
Thorpe, KE ;
Meldrum, HE ;
Spence, JD .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (20) :1415-1425
[3]   Determination of sixty percent or greater carotid artery stenosis by duplex Doppler ultrasonography [J].
Carpenter, JP ;
Lexa, FJ ;
Davis, JT .
JOURNAL OF VASCULAR SURGERY, 1995, 22 (06) :697-705
[4]   DETECTION OF CAROTID STENOSIS - FROM NASCET RESULTS TO CLINICAL-PRACTICE [J].
CHANG, YJ ;
GOLBY, AJ ;
ALBERS, GW .
STROKE, 1995, 26 (08) :1325-1328
[5]  
Elgersma OEH, 1999, J ULTRAS MED, V18, P191
[6]   ACCURACY AND PROGNOSTIC CONSEQUENCES OF ULTRASONOGRAPHY IN IDENTIFYING SEVERE CAROTID-ARTERY STENOSIS [J].
ELIASZIW, M ;
RANKIN, RN ;
FOX, AJ ;
HAYNES, RB ;
BARNETT, HJM .
STROKE, 1995, 26 (10) :1747-1752
[7]   Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European carotid surgery trial (ECST) [J].
Farrell, B ;
Fraser, A ;
Sandercock, P ;
Slattery, J ;
Warlow, CP .
LANCET, 1998, 351 (9113) :1379-1387
[8]   Ability to use duplex US to quantify internal carotid arterial stenoses: Fact or fiction? [J].
Grant, EG ;
Duerinckx, AJ ;
El Saden, SM ;
Melany, ML ;
Hathout, GM ;
Zimmerman, PT ;
Marumoto, AK ;
Cohen, SN ;
Baker, JD .
RADIOLOGY, 2000, 214 (01) :247-252
[9]   Cerebrovascular disease assessed by color-flow and power Doppler ultrasonography - Comparison with digital subtraction angiography in internal carotid artery stenosis [J].
Griewing, B ;
Morgenstern, C ;
Driesner, F ;
Kallwellis, G ;
Walker, ML ;
Kessler, C .
STROKE, 1996, 27 (01) :95-100
[10]   MEASUREMENT OF OBSERVER AGREEMENT FOR CATEGORICAL DATA [J].
LANDIS, JR ;
KOCH, GG .
BIOMETRICS, 1977, 33 (01) :159-174