Near-occlusion is difficult to diagnose with common carotid ultrasound methods.
Neuroradiology
; 63(5): 721-730, 2021 May.
Article
em En
| MEDLINE
| ID: mdl-33715027
ABSTRACT
PURPOSE:
To assess the sensitivity and specificity of common carotid ultrasound method for carotid near-occlusion diagnosis.METHODS:
Five hundred forty-eight patients examined with both ultrasound and CTA within 30 days of each other were analyzed. CTA graded by near-occlusion experts was used as reference standard. Low flow velocity, unusual findings, and commonly used flow velocity parameters were analyzed.RESULTS:
One hundred three near-occlusions, 272 conventional ≥50% stenosis, 162 <50% stenosis, and 11 occlusions were included. Carotid ultrasound was 22% (95%CI 14-30%; 23/103) sensitive and 99% (95%CI 99-100%; 442/445) specific for near-occlusion diagnosis. Near-occlusions overlooked on ultrasound were found misdiagnosed as occlusions (n = 13, 13%), conventional ≥50% stenosis (n = 65, 63%) and < 50% stenosis (n = 2, 2%). No velocity parameter or combination of parameters could identify the 65 near-occlusions mistaken for conventional ≥50% stenoses with >75% sensitivity and specificity.CONCLUSION:
Near-occlusion is difficult to diagnose with commonly used carotid ultrasound methods. Improved carotid ultrasound methods are needed if ultrasound is to retain its position as sole preoperative modality.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças das Artérias Carótidas
/
Estenose das Carótidas
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article