Key result
4D/3D power Doppler ultrasound matches angiography and duplex ultrasound for grading carotid stenosis.
Why the study?
Assessment of the severity of internal carotid artery stenosis is relevant to therapeutic decisions, and the accuracy of 4D/3D power-Doppler ultrasonography compared with angiography and other ultrasound methods needed evaluation.
Does 4D/3D-P-US accurately quantify carotid artery stenosis compared to angiography, 4D/3D-C-US, and DUS in patients with internal carotid artery stenosis?
Observational (n=36)
Blinded observers
Does 4D/3D-P-US accurately quantify carotid artery stenosis compared to angiography, 4D/3D-C-US, and DUS in patients with internal carotid artery stenosis?
p-value: p=>0.5
4D/3D power-Doppler ultrasonography provides accurate quantification of carotid artery stenosis comparable to angiography, color-Doppler, and 2D duplex ultrasonography.
4D/3D power-Doppler US shows non-inferior carotid stenosis grading versus angiography; leaves open routine adoption pending larger prospective validation.
Assessment of the severity of internal carotid artery stenosis is relevant to therapeutic decisions. Direct measurement of stenosis in static three-dimensionally rendered ultrasonographic color-Doppler images after an orientation with 4-D gray-scale views (4D/3D-C-US) was recently observed to be metrically non-inferior to angiography. In the study described here, power-Doppler (Christian Doppler was a physicist) ultrasonography (4D/3D-P-US) was prospectively compared with angiography, 4D/3D-C-US and 2-D duplex ultrasonography (DUS) in a similar fashion using blinded observers. Percentage stenosis was measured in 36 patients. Continuous percentage stenosis measures (standard deviation of difference and concordance correlation coefficient) between angiography and 4D/3D-P-US did not differ from the results between angiography observers (p > 0.05). Dichotomous diagnosis with 4D/3D-P-US resulted in κ values similar to the inter-rater agreement of angiography and the inter-method agreement of 4D/3D-C-US and DUS compared with angiography. Binary accuracy did not differ between 4D/3D-P-US, 4D/3D-C-US and DUS (p > 0.5). In conclusion, stenosis grading using 4D/3D-P-US exhibited non-inferior inter-method agreement with angiography at good accuracies, similar to 4D/3D-C-US and DUS.
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Macharzina et al. (2020) conducted an observational in Internal carotid artery stenosis (n=36). 4-D-supported 3-D power-Doppler ultrasonography (4D/3D-P-US) vs. Angiography, 4D/3D-C-US, and 2-D duplex ultrasonography (DUS) was evaluated on Percentage stenosis and binary diagnostic accuracy (p=>0.5). Stenosis grading using 4D/3D-P-US exhibited non-inferior inter-method agreement with angiography, with binary accuracy similar to 4D/3D-C-US and DUS (p > 0.5).
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