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Doppler Criteria for Identifying Proximal Vertebral Artery Stenosis of 50% or More
Author(s) -
Yurdakul Mehmet,
Tola Muharrem
Publication year - 2011
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2011.30.2.163
Subject(s) - medicine , digital subtraction angiography , stenosis , vertebral artery , radiology , receiver operating characteristic , angiography , artery , subtraction , diastole , doppler effect , cardiology , blood pressure , physics , arithmetic , mathematics , astronomy
Objectives The proximal segment of the vertebral artery is a frequent site of obstructive atherosclerosis. The purpose of this study was to determine Doppler criteria for identifying proximal vertebral artery stenosis of 50% or more by comparison with digital subtraction angiography. Methods Forty‐eight patients with vertebral artery stenosis were examined prospectively with color Doppler sonography and digital subtraction angiography. The peak systolic velocity (PSV), end‐diastolic velocity (EDV), peak systolic velocity ratio (PSVr), and end‐diastolic velocity ratio (EDVr) were evaluated by receiver operating characteristic curve analysis for their ability to detect vertebral artery stenosis of 50% or more. The optimal criteria for identifying proximal vertebral artery stenosis of 50% or more were determined. Results For identifying vertebral artery stenosis, the parameter with the highest accuracy was the PSVr (area under the receiver operating characteristic curve, 0.967 [95% confidence interval, 0.899–0.994]). A PSVr of greater than 2.2 was found to be the optimal criterion for identifying proximal vertebral artery stenosis of 50% or more, with sensitivity and specificity of 96% and 89%, respectively. The optimal thresholds for the other Doppler parameters in identifying proximal vertebral artery stenosis of 50% or more were as follows: PSV, greater than 108 cm/s; EDV, greater than 36 cm/s; and EDVr, greater than 1.7. Conclusions Color Doppler sonography is an accurate method for identifying proximal vertebral artery stenosis. The PSVr is superior to other Doppler parameters for detecting vertebral artery stenosis.