de Smet A A, Kitslaar P J
Department of Surgery, University Hospital Maastricht, The Netherlands.
Eur J Vasc Surg. 1990 Jun;4(3):275-8. doi: 10.1016/s0950-821x(05)80207-5.
Duplex scanning is a new non-invasive test, which enables direct evaluation of aorto-iliac stenoses. The usual duplex criterion for an arterial stenosis is local increase in peak systolic velocity. For haemodynamically significant aorto-iliac stenoses a threshold value for this increase has not yet been established. In order to define a duplex criterion for significant aorto-iliac disease. The whole segment was scanned to locate areas with high peak systolic velocities which were then compared to the velocities recorded immediately up and downstream. The value of the highest proportional velocity change was used as the criterion for duplex classification of the segment. Duplex results were compared to the outcome of invasive femoral artery pressure measurements combined with reactive hyperaemia (FAP test). For a range of threshold values of the duplex criterion the specificity and sensitivity was calculated using the FAP test as the gold standard (R.O.C. analysis). The combinations of the highest sensitivity and specificity were obtained in the range of 100-200% change in peak systolic velocity as duplex criteria for significant aorto-iliac stenosis. The highest accuracy (88%) was obtained at a 200% change in the peak systolic velocity.
双功扫描是一种新的无创检查方法，可直接评估主-髂动脉狭窄。动脉狭窄的常用双功标准是收缩期峰值速度局部增加。对于具有血流动力学意义的主-髂动脉狭窄，尚未确定这种增加的阈值。为了确定有意义的主-髂动脉疾病的双功标准，对整个节段进行扫描以定位收缩期峰值速度高的区域，然后将其与紧邻的上游和下游记录的速度进行比较。最高比例速度变化值用作该节段双功分类的标准。将双功结果与有创股动脉压力测量结合反应性充血（FAP试验）的结果进行比较。对于双功标准的一系列阈值，以FAP试验作为金标准计算特异性和敏感性（ROC分析）。作为有意义的主-髂动脉狭窄的双功标准，在收缩期峰值速度变化100%-200%的范围内获得了最高敏感性和特异性的组合。在收缩期峰值速度变化200%时获得了最高准确度（88%）。
