Power Doppler imaging: Initial evaluation as a screening examination for carotid artery stenosis

被引:43
作者
Bluth, EI
Sunshine, JH
Lyons, JB
Beam, CA
Troxclair, LA
Althans-Kopecky, L
Crewson, PE
Sullivan, MA
Smetherman, DH
Heidenreich, PA
Neiman, HL
Burkhardt, JH
机构
[1] Ochsner Fdn Hosp, Dept Radiol, New Orleans, LA 70121 USA
[2] Amer Coll Radiol, Res Dept, Reston, VA USA
[3] Western Penn Hosp, Dept Radiol, Pittsburgh, PA 15224 USA
[4] Med Coll Wisconsin, Dept Family & Community Med, Milwaukee, WI 53226 USA
[5] Stanford Univ, Palo Alto VA Hlth Care Syst, Dept Med, Stanford, CA 94305 USA
关键词
carotid arteries; angiography; stenosis or obstruction; US; ultrasound; (US); Doppler studies; power Doppler studies;
D O I
10.1148/radiology.215.3.r00jn22791
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To evaluate power Doppler imaging as a possible screening examination for carotid artery stenosis. MATERIALS AND METHODS: In the principal pilot study, a prospective, blinded comparison of power Doppler imaging with duplex Doppler imaging, the reference-standard method, was conducted in 100 consecutive patients routinely referred for carotid artery imaging at a large, private multispecialty clinic. In the validation pilot study, a prospective, blinded comparison of power Doppler imaging with digital subtraction angiography, the reference-standard method, was conducted in 20 consecutive patients routinely referred at a teaching hospital. Using conservative assumptions, the authors performed cost-effectiveness analysis. RESULTS: Power Doppler imaging produced diagnostic-quality images in 89% of patients. When the images of the patients with nondiagnostic examinations were regarded as positive, power Doppler imaging had an area under the receiver operating characteristic curve, A, of 0.87, sensitivity of 70%, and specificity of 91 %. The validation study results were very similar. The cost-effectiveness of screening and, as indicated, duplex Doppler imaging as the definitive diagnostic examination and endarterectomy was $47,000 per quality-adjusted life-year. CONCLUSION: The A, value for power Doppler imaging compares well with that for mammography, a generally accepted screening examination, and with most other imaging examinations. Power Doppler imaging is likely to be a reasonably accurate and cost-effective screening examination for carotid artery stenosis in asymptomatic populations.
引用
收藏
页码:791 / 800
页数:10
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