Comparison of Carotid Stenosis Grading by CT Angiography and Doppler Ultrasonography: How the Statistical Methods Applied Influence the Results
In this study, we compared the measurement of carotid stenosis by computed tomography angiography (CTA) based on the narrowest diameter versus cross sectional area (CSA) with the measurement by color Doppler ultrasonography (CDUS) as a reference standard, and analyzed how the application of diffe...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2021-01-01
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| Series: | Acta Clinica Croatica |
| Subjects: | |
| Online Access: | https://hrcak.srce.hr/file/393695 |
| Summary: | In this study, we compared the measurement of carotid stenosis by computed tomography
angiography (CTA) based on the narrowest diameter versus cross sectional area (CSA) with
the measurement by color Doppler ultrasonography (CDUS) as a reference standard, and analyzed
how the application of different statistical methods affected the result. On 113 carotid arteries with
≥50% stenosis, we quantified the level of correlation among the three measurements, sensitivity, specificity,
and differences in the estimated stenosis level. Correlation between both CTA measurements
was good with Pearson’s ρ between 0.87 and 0.91 (p<0.001). Correlation between CDUS and CTA
measurements was only modest with Pearson’s ρ between 0.2 (p=0.075) and 0.4 (p=0,007) for CDUS
CTA (CSA), and between 0.23 (p=0.062) and 0.39 (p=0.008) for CDUS CTA (diameter). Differences
in stenosis between CTA (CSA) and CDUS were centered around 0%, and between CTA (diameter)
and CDUS around 20%. Sensitivity and specificity for CTA (CSA) method were 81% and
77%, and for CTA (diameter) 23% and 100%, respectively. A good correlation between CSA and diameter
measurement just means that these are two related features of stenosis, it does not mean good
agreement. CTA (CSA) method better detected surgical stenoses, whereas CTA (diameter) systematically
underestimated stenosis level. The study of differences between the measurements indicated
agreement better than the calculation of correlation coefficients. |
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| ISSN: | 0353-9466 1333-9451 |