engleski

Sensitivity and specificity of color duplex doppler ultrasound in relation to carotid artery angiography findings in patients with carotid artery stenosis treated at Clinical Hospital of Rijeka, Croatia

Color duplex Doppler /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 magnetic angiography /MRA/, multi slice computerized carotidography /MSCT/ and digital subtraction carotidography /DSA/. Examinees: Data for 108 patients /75 male, 33 female/, treated at the Neurology clinic from 1.1.2005. – 31.8.2006, and had CDFI diagnostic was evaluated. The average age of the patients was 67 years /ranging from 44 to 81/. 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: In total, 61 MSCT carotidography, 53 DSA and 15 MRA ware made. The diagnosis of significant internal carotid stenosis was established: with DSA only in 31%, with MSCT only in 37% and with MRA only in 13% of all patients. For 19% of patients diagnosis was established with two, or in one case with all three methods. Unilateral internal carotid artery occlusion was diagnosed in 21 patients and in 52% the diagnosis was established with MSCT carotidography. The combination of ultrasound findings and these three methods has shown 94% (95% CI 89%-97%) sensitivity and 76% (95% CI: 64%-85%) specificity. Positive predictive value /PPV/ in our findings was 91% (95% CI: 88%-93%), with negative predictive value /NPV/ at 83% (95% CI: 74%-89%). 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. If the aim of early diagnosis and treatment of carotid artery disease as well as low cost diagnosis and treatment is to be reached, the diagnosis should be established using CDFI diagnostic with only one invasive angiography method in a Neurology Ultrasound Laboratory which fulfills the given criteria of high specificity and sensitivity.

specificity; sensitivity; angiography; carotid artery; stenosis

Abstracts of 11th Congress of the European Federation of neurological Societies, Brussels, Belgium. August 25-28, 2007