Determination of the extent of lower-extremity peripheral arterial disease with color-assisted duplex sonography: comparison with angiography.

Color-assisted duplex sonography combines color Doppler flow imaging with duplex sonography to rapidly survey the vasculature. Color Doppler sonography displays the motion of flowing blood on a sonogram and is used to visualize directly arterial lumen narrowing of greater than 50%. Absence of Doppler signals signifies arterial occlusion. Preangiographic triage of patients for surgical or interventional therapy requires that a rapid and accurate survey be performed of the extent of arterial disease. Color-assisted duplex sonography was applied prospectively in 17 consecutive patients with the clinical diagnosis of peripheral arterial disease who had not previously undergone angiography. Results of angiography of the femoropopliteal arteries were graded and localized in one of seven approximately equal arterial segments. These were compared with similar segmental maps made with sonography. For the detection of stenosis or occlusion in any of the 238 segments, the sensitivity was 0.88 (49/56), specificity 0.95 (173/182), and accuracy 0.93 (222/238). The average time taken to survey both limbs was 29 min. We conclude that color-assisted duplex sonography is an accurate and rapid tool for the noninvasive mapping of the extent of femoropopliteal arterial disease.