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AJR Am J Roentgenol. 1993 Mar;160(3):619-25.

Detection and quantification of carotid artery stenosis: efficacy of various Doppler velocity parameters.

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1
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate and compare the accuracies of the different Doppler velocity parameters used to grade stenoses of the carotid artery.

MATERIALS AND METHODS:

Seven velocity parameters determined with Doppler spectra were compared with angiographic findings in 138 carotid bifurcations: the peak systolic and peak end-diastolic velocities in the internal and common carotid arteries, the ratios of peak systolic and peak end-diastolic velocities between the internal and common carotid arteries, and the ratio of peak systolic velocity in the internal carotid artery to peak end-diastolic velocity in the common carotid artery. A receiver-operating-characteristic (ROC) analysis was performed, with and without correction for the bias introduced by preferentially selecting patients for angiography, if the Doppler results indicated a lesion. Multiple regression analysis was performed to predict the percent stenosis and to predict the probability of a 70% or greater stenosis.

RESULTS:

Of the Doppler parameters, the peak systolic velocity in the internal carotid artery and its ratio to the peak end-diastolic velocity in the common carotid artery were the most accurate and had equivalent test performance (ROC area = 0.94; after correction for verification bias, ROC area = 0.78). In multiple regression analysis, the peak systolic velocity in the internal carotid artery was the most significant parameter, although its ratio to the peak end-diastolic velocity in the common carotid artery had incremental value in detecting a 70% or greater stenosis, and the peak systolic velocity in the common carotid artery provided additional information for quantifying the stenosis.

CONCLUSION:

The peak systolic velocity in the internal carotid artery is the best single velocity parameter for quantifying a stenosis and for detecting a 70% or greater stenosis.

PMID:
8430567
DOI:
10.2214/ajr.160.3.8430567
[Indexed for MEDLINE]
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