Prediction of angiographic carotid artery stenosis indexes by colour Doppler-assisted duplex imaging.: A critical appraisal of the parameters used

被引:12
作者
Bönig, L
Weder, B [1 ]
Schött, D
Keel, A
Nguyen, T
Zaunbauer, W
机构
[1] Kantonsspital St Gallen, Neurol Klin, Dept Neurol, CH-9007 St Gallen, Switzerland
[2] Kantonsspital St Gallen, Inst Radiol, CH-9007 St Gallen, Switzerland
[3] Univ St Gallen, Inst Stat, CH-9000 St Gallen, Switzerland
关键词
colour Doppler-assisted duplex imaging; digital subtraction angiography; internal carotid artery stenosis; prediction of stenosis index; receiver operator characteristic graph;
D O I
10.1046/j.1468-1331.2000.00031.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The aim of our study was to establish colour Doppler-assisted duplex imaging (CDDI)-criteria to predict an angiographic internal carotid artery (ICA) stenosis of at least 70%, according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trialists (ECST) methods of measurement. In the following, we describe the findings in 79 patients who were screened for carotid endarterectomy by CDDI and further evaluated by digital subtraction angiography (DSA). In 158 carotid arteries, 107 stenoses of > 30% and nine occlusions were found. Receiver operator characteristic graphs were constructed in order to calculate sensitivities and specificities of the assessment by CDDI in the prediction of high-grade stenoses determined by angiography. Optimal cut-off points were defined by highest accuracy which reflects the combination of high sensitivity and specificity, The critical index of a high-grade ICA stenosis according to the ECST method could be predicted with an accuracy greater than 90% by a systolic peak velocitiy of 1.25 m/s or an area reduction by CDDI of 70%. Corresponding values, 1.6 m/s and 80% area reduction, predicted the stenosis indexes according to the NASCET method less reliably, with accuracies of between 80% and 90%. Flow velocity criterion was slightly less accurate than the area reduction criterion by CDDI. Finally, double-blind evaluation performed by two readers per examination modality showed that the measurement of area reduction in CDDI is at least as reliable as stenosis indexes according to ECST and NASCET methods.
引用
收藏
页码:183 / 190
页数:8
相关论文
共 34 条
[1]   MEASURING CAROTID STENOSIS - TIME FOR A REAPPRAISAL [J].
ALEXANDROV, AV ;
BLADIN, CF ;
MAGGISANO, R ;
NORRIS, JW .
STROKE, 1993, 24 (09) :1292-1296
[2]   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
[3]   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
[4]   SYMPTOMATIC CAROTID-ARTERY STENOSIS - A SOLVABLE PROBLEM - NORTH-AMERICAN SYMPTOMATIC CAROTID ENDARTERECTOMY TRIAL [J].
BARNETT, HJM ;
BARNES, RW ;
CLAGETT, GP ;
FERGUSON, GG ;
ROBERTSON, JT ;
WALKER, PM .
STROKE, 1992, 23 (08) :1048-1053
[5]   Carotid duplex overestimation of stenosis due to severe contralateral disease [J].
Busuttil, SJ ;
Franklin, DP ;
Youkey, JR ;
Elmore, JR .
AMERICAN JOURNAL OF SURGERY, 1996, 172 (02) :144-147
[6]   Determination of duplex Doppler ultrasound criteria appropriate to the North American Symptomatic Carotid Endarterectomy Trial [J].
Carpenter, JP ;
Lexa, FJ ;
Davis, JT .
STROKE, 1996, 27 (04) :695-699
[7]   OBSERVER VARIABILITY IN EVALUATING EXTRA-CRANIAL CAROTID-ARTERY STENOSIS [J].
CHIKOS, PM ;
FISHER, LD ;
HIRSCH, JH ;
HARLEY, JD ;
THIELE, BL ;
STRANDNESS, DE .
STROKE, 1983, 14 (06) :885-892
[8]   Accuracy of carotid duplex is laboratory specific and must be determined by internal audit [J].
Curley, PJ ;
Norrie, L ;
Nicholson, A ;
Galloway, JMD ;
Wilkinson, ARW .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 1998, 15 (06) :511-514
[9]   COMPLICATIONS OF CEREBRAL-ANGIOGRAPHY IN PATIENTS WITH SYMPTOMATIC CAROTID TERRITORY ISCHEMIA SCREENED BY CAROTID ULTRASOUND [J].
DAVIES, KN ;
HUMPHREY, PR .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1993, 56 (09) :967-972
[10]   STENOSIS OF THE INTERNAL CAROTID-ARTERY - ASSESSMENT USING COLOR DOPPLER IMAGING COMPARED WITH ANGIOGRAPHY [J].
ERICKSON, SJ ;
MEWISSEN, MW ;
FOLEY, WD ;
LAWSON, TL ;
MIDDLETON, WD ;
QUIROZ, FA ;
MACRANDER, SJ ;
LIPCHIK, EO .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1989, 152 (06) :1299-1305