IDENTIFYING TOTAL CAROTID OCCLUSION WITH COLOR FLOW DUPLEX SCANNING

被引:37
作者
MATTOS, MA [1 ]
HODGSON, KJ [1 ]
RAMSEY, DE [1 ]
BARKMEIER, LD [1 ]
SUMNER, DS [1 ]
机构
[1] SO ILLINOIS UNIV,SCH MED,DEPT SURG,PERIPHERAL VASC SURG SECT,POB 19230,SPRINGFIELD,IL 62794
来源
EUROPEAN JOURNAL OF VASCULAR SURGERY | 1992年 / 6卷 / 02期
关键词
COLOR FLOW SCANNING; DUPLEX SCANNING; TOTAL CAROTID OCCLUSION;
D O I
10.1016/S0950-821X(05)80242-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A major limitation of conventional duplex scanning is its inability reliably to differentiate severe stenosis from total occlusion of the internal carotid artery (ICA). Colour flow duplex scanning (CFS) facilitates the identification of internal and external carotid arteries, enables simultaneous evaluation of flow in multiple vessels in longitudinal and transverse views, and allows more accurate assessment of very low Doppler-shift frequencies with new "slow-flow" software technology. From July 1987 to January 1991, 9731 ICAs (4866 patients) were evaluated with CFS. Arteriography was performed in 483 of these patients (959 ICAs), and the results of the two studies were compared. Colour flow scanning was highly accurate in differentiating total occlusion from carotid stenosis. Eighty-two of 87 totally occluded ICAs were detected (sensitivity 94%) and 873 of 878 patent arteries were properly identified (specificity 99%). Positive and negative predictive values were 93 and 99%, respectively. False positive results (n = 6) were due to interpreter error (n = 4) and poor scanning technique (n = 2). All false negative results (n = 5) were the result of interpreter error. During the last 24 months of the study, no false positive or false negative results were detected, giving an accuracy of 100%. We conclude that CFS offers distinct advantages in the diagnosis of carotid occlusion, thereby overcoming the limitations of conventional duplex scanning in distinguishing total occlusion of the ICA from less sever disease, and is the method of choice for evaluating the carotid bifurcation.
引用
收藏
页码:204 / 210
页数:7
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