Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography
Introduction: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference te...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2010-01-01
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| Series: | Neurología (English Edition) |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2173580810700675 |
| _version_ | 1819265814270836736 |
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| author | J.C. Portilla Cuenca J.M. Ramírez-Moreno L. Fernández de Alarcón I. García Castañón M. Caballero Muñoz A. Serrano Cabrera A. Falcón García M. Gómez Gutierrez I. Casado Naranjo |
| author_facet | J.C. Portilla Cuenca J.M. Ramírez-Moreno L. Fernández de Alarcón I. García Castañón M. Caballero Muñoz A. Serrano Cabrera A. Falcón García M. Gómez Gutierrez I. Casado Naranjo |
| author_sort | J.C. Portilla Cuenca |
| collection | DOAJ |
| description | Introduction: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference technique, ultrasound study (UST) is a more readily available, non-invasive and well-established procedure for quantifying carotid stenosis. However, on being a dependent exploratory technique, it is recommended that each laboratory validates its results against angiography. Objectives: To establish the validity of the neuro-ultrasound study in our laboratory for use in the diagnosis of extracranial atheromatous disease, and determine its capacity to quantify the degree of stenosis in the internal carotid artery. Material and methods: A retrospective study of patients with extracranial carotid atheromatous disease, in whom the diagnostic process was carried out with carotid ultrasound as well as supra-aortic trunk digital-subtraction angiography. Results: A total of 254 carotids were evaluated and the degree of stenosis being classified into >50%, 70–99% and 100%. The UST for the fi rst group had a sensitivity (Se) of 97%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 94.6% and a negative predictive value (NPV) of 94.2%. The second group had a Se of 96.4%, Sp 93%; PPV 94.4% and NPV 95.4%. The respective values for carotid occlusion were, 85%, 96.8%, 80% and 97.8%. Conclusions: Our data validates the ability of UST performed in our Laboratory to diagnose the degree of carotid stenosis. Resumen: Introducción: Se considera que la arteriosclerosis de las arterias extracraneales causa casi un tercio de los ictus isquémicos. El diagnóstico certero del grado de estenosis es fundamental para indicar la mejor estrategia terapéutica. Si bien la angiografía cerebral se considera la técnica de referencia, el estudio ultrasonográfico (EUS) es un procedimiento más disponible, no invasivo y bien establecido en la cuantifi cación de la estenosis carotídea. Sin embargo, al ser una técnica dependiente del explorador, se recomienda que cada laboratorio valide sus resultados frente a la angiografía. Objetivos: Establecer, en nuestro laboratorio, la validez del estudio neurosonológico en el diagnóstico de la enfermedad ateromatosa extracraneal y determinar su capacidad para cuantificar el grado de estenosis de la arteria carótida interna. Material y métodos: Estudio retrospectivo de los pacientes con enfermedad ateromatosa carotídea extracraneal en cuyo proceso diagnóstico se realizó tanto ultrasonografía carotídea como angiografía por sustracción digital de troncos supraaórticos. Resultados: Se evaluaron 254 carótidas clasifi cando el grado de estenosis en > 50%, 70–99% y 100%. Para el primer grupo el EUS obtuvo una sensibilidad del 97%, una especificidad del 90%, un valor predictivo positivo (VPP) del 94,6% y un VP negativo (VPN) del 94,2%. En el segundo grupo, se obtuvo: sensibilidad, 96,4%; especifi cidad, 93%; VPP, 94,4%, y VPN, 95,4%. Para la oclusión carotídea los valores respectivos fueron del 85, el 96,8, el 80 y el 97,8%. Conclusiones: Nuestros datos validan la capacidad del EUS realizado en nuestro laboratorio para el diagnóstico del grado de estenosis carotídea. Keywords: Cerebral angiography, Carotid atherosclerosis carotidea, Doppler, Extracraneal stenosis, Ultrasound study, Palabras clave: Angiografía cerebral, Aterosclerosis carotidea, Doppler, Estenosis extracraneal, Estudio ultrasonográfico |
| first_indexed | 2024-12-23T20:51:21Z |
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| institution | Directory Open Access Journal |
| issn | 2173-5808 |
| language | English |
| last_indexed | 2024-12-23T20:51:21Z |
| publishDate | 2010-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Neurología (English Edition) |
| spelling | doaj.art-d7c64f6df6314b8f8e1e7f4eb2b9e4432022-12-21T17:31:40ZengElsevier EspañaNeurología (English Edition)2173-58082010-01-01256357363Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiographyJ.C. Portilla Cuenca0J.M. Ramírez-Moreno1L. Fernández de Alarcón2I. García Castañón3M. Caballero Muñoz4A. Serrano Cabrera5A. Falcón García6M. Gómez Gutierrez7I. Casado Naranjo8Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, Spain; Corresponding author.Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, SpainServicio de Radiología, Hospital Infanta Cristina, Badajoz, SpainSección de Neurología, Hospital San Pedro de Alcántara, Cáceres, SpainSección de Neurología, Hospital San Pedro de Alcántara, Cáceres, SpainSección de Neurología, Hospital San Pedro de Alcántara, Cáceres, SpainSección de Neurología, Hospital San Pedro de Alcántara, Cáceres, SpainSección de Neurología, Hospital San Pedro de Alcántara, Cáceres, SpainSección de Neurología, Hospital San Pedro de Alcántara, Cáceres, Spain; Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad de Extremadura, SpainIntroduction: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference technique, ultrasound study (UST) is a more readily available, non-invasive and well-established procedure for quantifying carotid stenosis. However, on being a dependent exploratory technique, it is recommended that each laboratory validates its results against angiography. Objectives: To establish the validity of the neuro-ultrasound study in our laboratory for use in the diagnosis of extracranial atheromatous disease, and determine its capacity to quantify the degree of stenosis in the internal carotid artery. Material and methods: A retrospective study of patients with extracranial carotid atheromatous disease, in whom the diagnostic process was carried out with carotid ultrasound as well as supra-aortic trunk digital-subtraction angiography. Results: A total of 254 carotids were evaluated and the degree of stenosis being classified into >50%, 70–99% and 100%. The UST for the fi rst group had a sensitivity (Se) of 97%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 94.6% and a negative predictive value (NPV) of 94.2%. The second group had a Se of 96.4%, Sp 93%; PPV 94.4% and NPV 95.4%. The respective values for carotid occlusion were, 85%, 96.8%, 80% and 97.8%. Conclusions: Our data validates the ability of UST performed in our Laboratory to diagnose the degree of carotid stenosis. Resumen: Introducción: Se considera que la arteriosclerosis de las arterias extracraneales causa casi un tercio de los ictus isquémicos. El diagnóstico certero del grado de estenosis es fundamental para indicar la mejor estrategia terapéutica. Si bien la angiografía cerebral se considera la técnica de referencia, el estudio ultrasonográfico (EUS) es un procedimiento más disponible, no invasivo y bien establecido en la cuantifi cación de la estenosis carotídea. Sin embargo, al ser una técnica dependiente del explorador, se recomienda que cada laboratorio valide sus resultados frente a la angiografía. Objetivos: Establecer, en nuestro laboratorio, la validez del estudio neurosonológico en el diagnóstico de la enfermedad ateromatosa extracraneal y determinar su capacidad para cuantificar el grado de estenosis de la arteria carótida interna. Material y métodos: Estudio retrospectivo de los pacientes con enfermedad ateromatosa carotídea extracraneal en cuyo proceso diagnóstico se realizó tanto ultrasonografía carotídea como angiografía por sustracción digital de troncos supraaórticos. Resultados: Se evaluaron 254 carótidas clasifi cando el grado de estenosis en > 50%, 70–99% y 100%. Para el primer grupo el EUS obtuvo una sensibilidad del 97%, una especificidad del 90%, un valor predictivo positivo (VPP) del 94,6% y un VP negativo (VPN) del 94,2%. En el segundo grupo, se obtuvo: sensibilidad, 96,4%; especifi cidad, 93%; VPP, 94,4%, y VPN, 95,4%. Para la oclusión carotídea los valores respectivos fueron del 85, el 96,8, el 80 y el 97,8%. Conclusiones: Nuestros datos validan la capacidad del EUS realizado en nuestro laboratorio para el diagnóstico del grado de estenosis carotídea. Keywords: Cerebral angiography, Carotid atherosclerosis carotidea, Doppler, Extracraneal stenosis, Ultrasound study, Palabras clave: Angiografía cerebral, Aterosclerosis carotidea, Doppler, Estenosis extracraneal, Estudio ultrasonográficohttp://www.sciencedirect.com/science/article/pii/S2173580810700675 |
| spellingShingle | J.C. Portilla Cuenca J.M. Ramírez-Moreno L. Fernández de Alarcón I. García Castañón M. Caballero Muñoz A. Serrano Cabrera A. Falcón García M. Gómez Gutierrez I. Casado Naranjo Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography Neurología (English Edition) |
| title | Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography |
| title_full | Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography |
| title_fullStr | Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography |
| title_full_unstemmed | Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography |
| title_short | Validation of supra-aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery. Comparison of the results with angiography |
| title_sort | validation of supra aortic trunks ultrasound in the diagnosis of atherosclerotic disease of the internal carotid artery comparison of the results with angiography |
| url | http://www.sciencedirect.com/science/article/pii/S2173580810700675 |
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