Rule-out and rule-in of carotid near-occlusion using color duplex ultrasound.
Purpose: Diagnosing carotid near-occlusion (CNO) with colour duplex ultrasound (CDU) is challenging. We hypothesised that CNO is associated with a reduced distal internal carotid artery (ICA) velocity and aimed to assess if distal velocity is able to diagnose CNO accurately. If not, we aimed to deve...
| Publicado en: | Neuroradiology Vol. 67; no. 5; pp. 1223 - 1232 |
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| Autores principales: | , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Springer Nature
May2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=185594538&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 185594538 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283940 NYZ jtl: Neuroradiology issn: 00283940 maglogo: N pubinfo: dt: May2025 vid: 67 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 185594538 184515404 185594538 185594538 10.1007/s00234-025-03612-2 185594538 ppf: 1223 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Rule-out and rule-in of carotid near-occlusion using color duplex ultrasound. aug: au: Skoog, Johan Vanoli, Davide Henze, Alexander Fox, Allan J. Johansson, Elias affil: https://ror.org/04vgqjj36 Department of Clinical Physiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden sug: subj: Carotid Stenosis Radiography Ultrasonography, Doppler, Color Human Prospective Studies Cross Sectional Studies Computed Tomography Angiography Descriptive Statistics Sensitivity and Specificity Blood Flow Velocity Evaluation ab: Purpose: Diagnosing carotid near-occlusion (CNO) with colour duplex ultrasound (CDU) is challenging. We hypothesised that CNO is associated with a reduced distal internal carotid artery (ICA) velocity and aimed to assess if distal velocity is able to diagnose CNO accurately. If not, we aimed to develop CDU rule-out and rule-in criteria to diagnose CNO. Methods: This is a prospective cross-sectional study in consecutive participants with suspected ≥ 50% carotid stenosis on CT angiography (CTA). CDU velocities in the common carotid artery, the stenosis and distal to the stenosis were examined. CTAs were assessed for CNO, serving as a reference test. If no CDU parameter was both sensitive and specific for CNO, rule-out (98% sensitive) and rule-in (99% specific) criteria were created. Results: Of the 315 included participants with ≥ 50% stenosis, 190 (60%) were conventional ≥ 50% stenosis and 125 (40%) CNO. No CDU parameter was both sensitive and specific for CNO. The best exclusion criteria were stenosis end diastolic velocity (EDV) ≤ 63 cm/s and/or distal peak systolic velocity (PSV) > 23 cm/s, seen in 115 (38%) participants. The best rule-in criteria were stenosis EDV ≥ 280 cm/s and/or distal PSV ≤ 23 cm/s, seen in 35 (12%) participants. Of the remaining participants, 143 (47%) were uncertain (74 CNOs) and 9 (3%) were misdiagnosed as carotid occlusion (all CNOs). Conclusions: CDU alone cannot diagnose CNO but can rule in or rule out CNO in half of participants with ≥ 50% stenosis. These criteria are intended for inclusion in an algorithm, sorting cases needing further exams, such as CTA and/or phase-contrast magnetic resonance angiography. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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