Key result
Aligning Doppler angle to blood flow improves diagnostic accuracy for ≥70% ICA stenosis versus vessel alignment.
Why the study?
Does Doppler angle correction aligned parallel to blood flow improve the diagnostic accuracy of peak systolic velocity for internal carotid artery stenosis compared to alignment parallel to the blood vessel?
Observational (n=50)
Does Doppler angle correction aligned parallel to blood flow improve the diagnostic accuracy of peak systolic velocity for internal carotid artery stenosis compared to alignment parallel to the blood vessel?
Absolute Event Rate: 0.973% vs 0.765%
Aligning the Doppler angle parallel to the blood flow at the stenotic lesion rather than the blood vessel improves the diagnostic accuracy of peak systolic velocity for severe internal carotid artery stenosis.
Objective: The jet flow direction at the stenotic lesion is not always parallel to the blood vessel direction. Therefore, we examined the optimal angle correction. Methods: Among 50 subjects with stenosis at the internal carotid artery (ICA) bifurcation who underwent carotid ultrasonography and digital subtraction angiography (DSA). The measurement of peak systolic velocity (PSV) at the stenotic lesion site was performed according to the guideline of Japan Academy of Neurosonology. The subjects were divided into 2 groups: group A, angle was aligned parallel to the blood flow at the stenotic lesion (n = 23) and group B, angle was aligned parallel to the blood vessel (n = 30). ICA stenosis was diagnosed on DSA images according to NASCET criteria. Results: In groups A and B, there was a significant correlation between PSV and stenosis ratio. In diagnosing ICA stenosis (≥ 70%), the area under ROC curve, the sensitivity and specificity of PSV were 0.973, 100% and 85.7% with a cutoff level of 203.5 cm/s and 0.765, 70.0% and 80.0% with a cutoff level 256.9 cm/s, respectively. Conclusion: Our study suggests the angle-adjustment towards the blood flow at the stenotic lesion site is superior to the angle-adjustment parallel to the blood vessel for PSV measurement.
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Igarashi et al. (2017) conducted an observational in Internal carotid artery stenosis (n=50). Angle-adjustment towards the blood flow vs. Angle-adjustment parallel to the blood vessel was evaluated on Area under the ROC curve (AUC) for diagnosing ≥70% ICA stenosis. Angle-adjustment towards the blood flow at the stenotic lesion site provided superior diagnostic accuracy for ≥70% internal carotid artery stenosis (AUC 0.973) compared to angle-adjustment parallel to the blood vessel (AUC 0.765).
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