engleski

COLOR DUPLEX DOPPLER ULTRASOUND IN PATIENTS WITH CAROTID ARTERY STENOSIS : ACCURACY OF NONINVASIVE TESTING

Study objectives: Carotid endarterectomy has been shown to be beneficial in symptomatic patients with a severe stenosis /70% to 99%/ of the internal carotid arteria /ICA/. Digital subtraction angiography /DSA/ is the standard of reference in the diagnosis of carotid stenosis but has a relatively high complication rate. Color duplex Doppler Flow Imagine /CDFI/ is a non-invasive method which, in wide application, brings to early detection of internal carotid artery disease. The aim of this prospective study was to ascertain specificity and sensitivity of the Neurosonology Laboratory for Neurology department of KBC Rijeka in detection of carotid artery stenosis in comparison to digital subtraction carotidography /DSA/. Examinees: Data for 138 patients /79 male, 59 female/, treated at the Neurology clinic from 1.1.2006. – 31.12.2007. and had CDFI diagnostic was evaluated. The average age of the patients was 62 years /ranging from 32 to 87/. Only patients with significant internal carotid artery stenosis over 70% /including carotid artery occlusions/ were taken into consideration. North American Symptomatic Carotid Endarterectomy Trial /NASCET/ criteria were used to determine the degree of stenosis. Results:. The diagnosis of significant internal carotid stenosis was established with DSA in 138 patient.. Unilateral internal carotid artery occlusion was diagnosed in 35 patients The combination of ultrasound findings and DSA methods has shown 94% (95% CI 89%-97%) sensitivity and 89% (95% CI: 77%-96%) specificity. Positive predictive value /PPV/ in our findings was 95% (95% CI: 88%-97%), with negative predictive value /NPV/ at 89% (95% CI: 79%-93%). Conclusion: noninvasive ultrasound diagnostic is a safe and secure method to be used in proving significant carotid disease. This is backed up with high sensitivity and positive predictive value of our ultrasound results in comparison to angiography results. Apropriate and adequate technical training, proficiency and experience are essential for the safe performance of procedures in screening carotid stenosis with noninvasive ultrasound diagnostic neuroimaging. Therefore, diagnosis could be established using only CDFI diagnostic without invasive angiography method in a Neurology Laboratory which fulfills the given criteria of high specificity and sensitivity.

stenoza karotidne arterije; color dupleks doplers; neivazivna pretraga

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