Barrado Pilar Caridad Morata, Méndez Miguel Muela, Palenzona Andrés Eduardo Recover, Oviedo Fernando Miguel Franch, Barrera Julio Reina, Requena Mercedes Guerra
Department of Angiology, Vascular and Endovascular Surgery, Hospital Universitario de Guadalajara, Calle Donante de Sangre, S/N, 19002, Guadalajara, Spain.
J Ultrasound. 2025 Mar;28(1):101-106. doi: 10.1007/s40477-024-00967-9. Epub 2024 Nov 15.
The present study analyzes the concordance between arterial mapping of this sector using duplex ultrasound and intraoperative angiography.
A retrospective, single-center observational study was carried out. The study sample consisted of patients subjected to open or endovascular surgery of the femoropopliteal and distal sector with prior ultrasound arterial mapping from January 2017 to December 2022. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of arterial mapping with duplex ultrasound versus intraoperative angiography were evaluated, the degree of concordance between the two techniques and the correlation between surgical planning and the surgery finally performed.
167 patients were analyzed. A total of 1837 segments were explored, of which 149 (8.1%) were not able to be evaluated. Regarding the global precision of ultrasound in predicting significant arterial lesions (stenosis > 50% or occlusion), sensitivity was 85.26% (95% confidence interval [95%CI]: 82.33-88.19%), specificity 88.57% (95%CI: 86.63-90.51%), PPV 80.41% (95%CI: 77.24-83.58%), and NPV 91.61% (95%CI: 89.89-93.34%). Global concordance assessed by the kappa index was 0.725 (95%CI: 0.691-759). The surgical indications based on arterial mapping coincided with the final surgery performed in 97.6% of the cases.
Arterial mapping of the femoropopliteal and distal sector with duplex ultrasound could be considered as the sole preoperative imaging technique for surgical planning.
本研究分析使用双功超声对该区域进行动脉成像与术中血管造影之间的一致性。
开展一项回顾性单中心观察性研究。研究样本包括2017年1月至2022年12月期间接受股腘及远端区域开放或血管内手术且术前行超声动脉成像的患者。评估双功超声动脉成像与术中血管造影的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV），两种技术之间的一致程度以及手术规划与最终实施手术之间的相关性。
分析了167例患者。共探查了1837个节段，其中149个（8.1%）无法评估。关于超声预测显著动脉病变（狭窄>50%或闭塞）的总体准确性，敏感性为85.26%（95%置信区间[95%CI]：82.33 - 88.19%），特异性为88.57%（95%CI：86.63 - 90.51%），PPV为80.41%（95%CI：77.24 - 83.58%），NPV为91.61%（95%CI：89.89 - 93.34%）。通过kappa指数评估的总体一致性为0.725（95%CI：0.691 - 759）。基于动脉成像的手术指征与最终实施的手术在97.6%的病例中相符。
使用双功超声对股腘及远端区域进行动脉成像可被视为手术规划的唯一术前成像技术。
