SPECTRAL-ANALYSIS CRITERIA IN DUPLEX SCANNING OF AORTOILIAC AND FEMOROPOPLITEAL ARTERIAL-DISEASE

To validate the use of duplex scanning in the detection of lesions in the aortoiliac and femoropopliteal arteries, duplex scanning was prospectively compared to intra-arterial digital subtraction angiography in 61 patients with peripheral atherosclerotic disease. Based on a peak systolic velocity ratio greater-than-or-equal-to 2.5 or the absence of a Doppler signal, the overall sensitivity and specificity to detect lesions of greater-than-or-equal-to 50% diameter reduction was 84% and 96%, although some segments in the femoropopliteal arteries showed a sensitivity of only 60%-70%. Occlusions were detected with an overall sensitivity of 92% and specificity of 99%. The existence of a bi/triphasic Doppler signal, a window in the systolic spectral waveform and an end diastolic velocity greater-than-or-equal-to 60 cm/s has additional value in further grading of stenoses. This study shows that duplex scanning is highly comparable to angiography in the detection greater-than-or-equal-to 50% diameter reducing lesions in the aortoiliac arteries. Further evaluation is needed for the femoropopliteal arteries.