Department of Radiology Policlinico Universitario, University of Cagliari s.s., 554 Monserrato, Cagliari 09045, Italy.
Eur J Radiol. 2010 Apr;74(1):99-103. doi: 10.1016/j.ejrad.2009.01.033. Epub 2009 Feb 26.
Stroke is a major cause of death and serious long-lasting neurological disability and the severity of carotid artery stenosis is one of the most important determinants of cerebrovascular events. The purpose of this paper is to evaluate the correlation between multi-detector-row CT angiography (MDCTA) and ultra-sound peak-systolic-velocity (US-PSV) in the quantification of carotid artery stenosis.
52 patients were retrospectively studied by using four-detector row CT and ultra-sound. Each patient was assessed for stenosis degree by using NASCET method when studied by using MDCT and by using PSV when studied by using US. Statistic analysis was performed to determine the entity of correlation (method of Pearson) between MDCTA and US-PSV. The Bland-Altman analysis was applied to assess the level of inter-technique agreement.
Sonographic PSV measurements ranged from 70 to 589cm/s. Distal ICA velocities ranged from 29 to 238cm/s. Linear regression analysis showed a good correlation (r(2)=0.613) between MDCTA-NASCET linear percentage stenosis and PSV and measured. PSV value that corresponded to a NASCET linear percentage stenosis of 70% was 283cm/s and with this values sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 75%, 88.6%, 90.7% and 70.5%, respectively.
Results of our study suggest that NASCET stenosis measured in MDCTA and PSV values have a good correlation. The use of a threshold of 283cm/s allows obtaining good value of sensitivity and specificity.
中风是死亡和严重持久神经功能障碍的主要原因,颈动脉狭窄的严重程度是决定脑血管事件最重要的因素之一。本文旨在评估多排 CT 血管造影(MDCTA)与超音波峰值收缩速度(US-PSV)在颈动脉狭窄定量中的相关性。
回顾性研究 52 例患者,使用四排 CT 和超音波进行检查。使用 MDCT 检查时,采用 NASCET 方法评估狭窄程度,使用 US 检查时,采用 PSV 评估狭窄程度。采用 Pearson 法进行统计学分析,以确定 MDCTA 与 US-PSV 之间的相关性(方法为 Pearson)。采用 Bland-Altman 分析评估两种技术之间的一致性程度。
超声 PSV 测量值范围为 70 至 589cm/s。颈内动脉远段速度范围为 29 至 238cm/s。线性回归分析显示 MDCTA-NASCET 线性百分比狭窄与 PSV 测量值之间存在良好的相关性(r²=0.613)。对应 NASCET 线性百分比狭窄 70%的 PSV 值为 283cm/s,该值的灵敏度、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为 75%、88.6%、90.7%和 70.5%。
本研究结果表明,MDCTA 测量的 NASCET 狭窄程度与 PSV 值之间存在良好的相关性。使用 283cm/s 的阈值可以获得良好的灵敏度和特异性。