RT Journal Article
SR Electronic
T1 Combined Use of Color Duplex Ultrasonography and B-Flow Imaging for Evaluation of Patients with Carotid Artery Stenosis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1856
OP 1860
VO 25
IS 10
A1 Muharrem Tola
A1 Mehmet Yurdakul
A1 Turhan Cumhur
YR 2004
UL http://www.ajnr.org/content/25/10/1856.abstract
AB BACKGROUND AND PURPOSE: Color duplex ultrasonography (CDU) is a standard method of noninvasive evaluation of internal carotid artery stenosis (ICAS). B-flow imaging (BFI), on the other hand, is a newer method. We investigated the accuracy of the two noninvasive tests—CDU and BFI—each separately and as a combination of the two tests by comparing with digital subtraction angiography as a reference standard.METHODS: We performed CDU, BFI, and digital subtraction angiography on 95 consecutive patients with ICAS. Separate and combined test results of CDU and BFI were compared with digital subtraction angiography results.RESULTS: For identifying 70% to 99% ICAS, as CDU criterion, the ratio of internal carotid artery to common carotid artery peak systolic velocity had the highest diagnostic accuracy (sensitivity, 94%; specificity, 96%). The sensitivity and specificity of BFI were 65% and 98%, respectively. With CDU and BFI, results were concordant in 144 (89%) cases for 70% to 99% ICAS. Sensitivity and specificity of combined CDU and BFI results for identification of ICAS were 95% and 99%, respectively. The misclassification rates of CDU and BFI were 4.7% and 8.1%, respectively. When combined test results were concordant, the misclassification rate decreased to 1.4%.CONCLUSION: CDU showed a slightly better accuracy than did BFI in the diagnosis of carotid artery stenosis. Combined use of CDU and BFI is more accurate than use of either test alone.