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Duplex ultrasonography is an efficient diagnostic tool for the detection of moderate to severe internal carotid artery stenosis
Author(s) -
Nowak Jacek,
Jogestrand Tomas
Publication year - 2007
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2007.00727.x
Subject(s) - medicine , internal carotid artery , stenosis , duplex ultrasonography , radiology , receiver operating characteristic , duplex (building) , diagnostic accuracy , ultrasound , angiography , doppler effect , ultrasonography , dna , genetics , physics , astronomy , biology
Summary Background The aim of this prospective national muliticentre study with 10 participating university and county hospitals was to establish the diagnostic accuracy of carotid duplex sonography in the identification of ≥70% internal carotid artery (ICA) stenosis defined according to European Carotid Surgery Trial (ECST) criteria. Methods In 134 patients, aged 69 ± 9 years, ICA stenoses were identified by routine carotid duplex ultrasonography, confirmed angiographically within 2 months, and graded according to ESCT criteria. The accuracy of carotid duplex to detect ICA stenosis ≥70% was assessed using receiver operating characteristic (ROC) analysis with carotid angiography as a reference. Results Measurement of peak systolic velocity in ICA (PSV ICA ) identified ICA stenosis ≥70% with high diagnostic accuracy that was Doppler angle dependent resulting in different optimal PSV ICA cut points within the angle range 0°–49° (1·7 m s −1 ) and 50°–62° (2·3 m s −1 ). The diagnostic discrimination was significantly better when narrow Doppler angles (0°–49°) were used ( P <0·01) providing the sensitivity of 98 ± 2% and specificity of 94 ± 4%. Discussion Ultrasound duplex technique identifies moderate to severe (≥70%) ICA stenoses (ECST criteria) with high degree of accuracy that can be further improved by the use of Doppler angle specific optimal PSV ICA cut points.