Bucek Robert A, Reiter Markus, Dirisamer Albert, Haumer Markus, Fritz Angelika, Minar Erich, Lammer Johannes
University Clinic for Radiology, Department of Angiography and Interventional Radiology, Vienna General Hospital, Vienna, Austria.
AJNR Am J Neuroradiol. 2003 Aug;24(7):1294-9.
Color Doppler sonography (CDS) suffers from such disadvantages as high interobserver variability and problems with data presentation and storage. We therefore performed a prospective trial to assess the role of three-dimensional CDS (3D-CDS) in the evaluation of internal carotid artery stenosis (ICAS).
We included 32 consecutive patients with sonographically verified ICAS (30-99%) and 16 asymptomatic volunteers. All underwent CDS and 3D-CDS, and 23 patients also underwent intraarterial angiography. The sensitivity, specificity, positive predictive value, and negative predictive value for the detection of high-grade ICAS were analyzed by three blinded readers, who also graded the percentage of ICAS.
CDS revealed 14 patients with mild to moderate ICAS and 18 patients with high-grade ICAS. Mean sensitivity of 3D-CDS was 81.5%, mean specificity was 98.9%, mean positive predictive value was 97.9%, and mean negative predictive value was 89.9%. 3D-CDS correlated significantly with CDS (mean r=0.85; P<.001) and angiography (mean r=0.57; P=.01).
3D-CDS findings correlate with those obtained by CDS and angiography; 3D-CDS also offers excellent interobserver correlation, positive predictive value, and specificity, approaching 100% for the detection of high-grade ICAS.
彩色多普勒超声检查（CDS）存在诸如观察者间差异大以及数据呈现和存储方面的问题等缺点。因此，我们进行了一项前瞻性试验，以评估三维彩色多普勒超声检查（3D-CDS）在评估颈内动脉狭窄（ICAS）中的作用。
我们纳入了32例经超声检查证实患有ICAS（30%-99%）的连续患者以及16名无症状志愿者。所有患者均接受了CDS和3D-CDS检查，其中23例患者还接受了动脉内血管造影。由三位不知情的阅片者分析检测高度ICAS的敏感性、特异性、阳性预测值和阴性预测值，他们还对ICAS的百分比进行了分级。
CDS显示14例轻度至中度ICAS患者和18例高度ICAS患者。3D-CDS的平均敏感性为81.5%，平均特异性为98.9%，平均阳性预测值为97.9%，平均阴性预测值为89.9%。3D-CDS与CDS（平均r=0.85；P<0.001）和血管造影（平均r=0.57；P=0.01）显著相关。
3D-CDS的检查结果与CDS和血管造影的结果相关；3D-CDS还具有出色的观察者间相关性、阳性预测值和特异性，检测高度ICAS时接近100%。
