| Mesenteric/celiac duplex ultrasound interpretation criteria revisited. | |
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MedLine Citation:
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PMID: 22195765 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Several published studies with a small sample size have reported differing results of duplex ultrasound (DUS) utilizing different threshold velocities in detecting significant stenosis of superior mesenteric (SMA) or celiac arteries (CA). The present study is based on the largest number of mesenteric duplex/angiography correlations reported to date for the diagnosis of SMA/CA stenosis. METHODS: One hundred fifty-three patients (151 SMA and 150 CA) had both DUS and arteriography. Receiver operator curves (ROC) were used to analyze peak systolic velocity (PSV), end diastolic velocity (EDV), and SMA or CA/aortic PSV ratio in detecting ≥50% and ≥70% stenosis. RESULTS: For SMA (151 arteries: 84 with ≥50% stenosis [54 of which had ≥70% stenosis] based on angiography): the PSV threshold that provided the highest overall accuracy (OA) for detecting ≥50% SMA stenosis was ≥295 cm/s (sensitivity [sens.] 87%, specificity [spec.] 89%, and OA 88%); and for detecting ≥70% SMA, it was ≥400 cm/s (sens. 72%, spec. 93%, and OA 85%). The EDV threshold that provided the highest OA for detecting ≥50% stenosis was ≥45 cm/s (sens. 79%, spec. 79%, and OA 79%); and for ≥70% stenosis was ≥70 cm/s (sens. 65%, spec. 95%, and OA 84%). ROC analysis showed that PSV was better than EDV and SMA/aortic PSV ratio for ≥50% stenosis of SMA (P = .003 and P = .0005). For celiac arteries (150 arteries: 105 with ≥50% stenosis [62 of which had ≥70% stenosis]): the PSV threshold that provided the highest OA for ≥50% stenosis was ≥240 cm/s (sens. 87, spec. 83%, and OA 86%); and for ≥70% stenosis was ≥320 cm/s (sens. 80%, spec. 89%, and OA 85%). The EDV threshold that provided the highest OA for ≥50% stenosis was ≥40 cm/s (sens. 84%, spec. 48%, and OA 73%); and for ≥70% stenosis was ≥100 cm/s (sens. 58%, spec. 91%, and OA 77%). ROC analysis showed that PSV was better than EDV and SMA/aortic PSV ratio for ≥50% stenosis of CA (P < .0001 and P = .0410.) CONCLUSIONS: PSV values can be used in detecting ≥50% and ≥70% SMA/CA stenosis and were better than EDVs and ratios. Previously published data must be validated in individual vascular laboratories. Our results will need prospective validation. |
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Authors:
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Ali F AbuRahma; Patrick A Stone; Mohit Srivastava; L Scott Dean; Tammi Keiffer; Stephen M Hass; Albeir Y Mousa |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2011-12-21 |
Journal Detail:
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Title: Journal of vascular surgery Volume: 55 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-23 Completed Date: 2012-03-12 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 428-436.e6; discussion 435-6 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV 25304, USA. ali.aburahma@camc.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angiography, Digital Subtraction Aortography Blood Flow Velocity Celiac Artery / physiopathology, radiography, ultrasonography* Chi-Square Distribution Constriction, Pathologic Female Humans Ischemia / physiopathology, radiography, ultrasonography* Male Mesenteric Artery, Superior / physiopathology, radiography, ultrasonography* Mesenteric Vascular Occlusion / physiopathology, radiography, ultrasonography* Middle Aged Predictive Value of Tests Prognosis ROC Curve Regional Blood Flow Reproducibility of Results Retrospective Studies Severity of Illness Index Ultrasonography, Doppler, Duplex* Vascular Diseases / physiopathology, radiography, ultrasonography* West Virginia Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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