| Concordance rates of Doppler ultrasound and CT angiography in the grading of carotid artery stenosis: a systematic literature review. | |
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MedLine Citation:
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PMID: 22064974 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Physicians have been increasingly relying on noninvasive imaging methods to grade carotid stenosis. The accuracy of Doppler ultrasound (DUS) and CT angiography (CTA) versus intra-arterial angiography (IA) has been assessed in many studies and at least two meta-analyses. Here, we performed a systematic review of studies that compared DUS to CTA. In a PubMed review of the literature from 2000 to 2009, we found 12 studies that compared DUS and CTA-based grading of carotid stenosis. Only 4 of them included at least 20 patients and provided data to classify the diseased arteries into the following categories: mild, moderate or severe NASCET stenosis or occlusion. We extracted 431 arteries from 244 patients (range per study: 48-164). It was not possible to distinguish symptomatic from asymptomatic stenoses. Nearly half arteries had severe stenosis (46% based on DUS and 43% based on CTA). The weighted kappa was 0.85 (95% CI 0.76-0.94), and the accuracy was 0.78. When the arteries were classified into medical and potentially surgical groups, the kappa was 0.76 (95% CI 0.70-0.83), and the accuracy was 0.89. Overall, 17 % of the stenoses classified as medical based on DUS were reclassified as surgical based on CTA and 14 % of the stenoses classified as medical based on CTA were reclassified as surgical based on DUS. The sparse available data comparing DUS and CTA suggest that the grading of a carotid stenosis as medical or potentially surgical remains uncertain in a relatively high proportion of patients. |
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Authors:
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Chiara Zavanone; Emma Ragone; Yves Samson |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-8 |
Journal Detail:
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Title: Journal of neurology Volume: - ISSN: 1432-1459 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0423161 Medline TA: J Neurol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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AP-HP Urgences Cérébro-Vasculaires, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie Paris VI, Paris Universitas, 47-83 Boulevard de l'Hôpital, 75013, Paris, France, chiara.zavanone@libero.it. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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