Accuracy of color duplex ultrasound diagnosis of spontaneous carotid dissection causing ischemia.

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State: Public
Version: Final published version
Serval ID
serval:BIB_9FC2DD37610A
Type
Article: article from journal or magazin.
Collection
Publications
Title
Accuracy of color duplex ultrasound diagnosis of spontaneous carotid dissection causing ischemia.
Journal
Stroke
Author(s)
Benninger D.H., Georgiadis D., Gandjour J., Baumgartner R.W.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
37
Number
2
Pages
377-381
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND AND PURPOSE: Spontaneous dissection of the cervical internal carotid artery (sICAD) is mainly assessed with MRI and magnetic resonance angiography (MRA), which are not always at hand. In contrast, color duplex sonography (CDS) is readily available. We undertook this prospective study to examine the accuracy of CDS to diagnose sICAD in patients with first carotid territory ischemia.
METHODS: Consecutive patients with first carotid territory stroke or transient ischemic attack or retinal ischemia underwent clinical and laboratory examinations, ECG, CDS of the cerebral arteries, cranial computed tomography in case of stroke or transient ischemic attack, and echocardiography and 24-hour ECG in selected cases. Patients were included, if they were <65 years of age, CDS showed a probable sICAD (cervical internal carotid artery stenosed or occluded), or had no determined etiology of ischemia. All of the included patients underwent cervical MRI and MRA+/-cerebral catheter angiography. The sonographer was blinded to the results of MRI and angiography studies.
RESULTS: We included 177 of 1652 screened patients. Excluded patients (n=1475) were > or =65 years old (n=818), had another determined cause of ischemia (n=1475), and had intracranial hemorrhage (n=58). CDS diagnosed sICAD in 77 of 177 patients, and the etiology of ischemia was undetermined in the remaining 100 patients. Cervical MRI and angiography showed 74 sICAD; there were 6 falsely positive and 3 falsely negative CDS findings. Thus, sensitivity, specificity, and positive and negative predictive values for CDS diagnosis of patients with sICAD causing carotid territory ischemia was 96%, 94%, 92%, and 97%, respectively.
CONCLUSIONS: Color duplex ultrasound allows the reliable exclusion of sICAD in patients with carotid territory ischemia, whereas diagnosis of CDS of sICAD must be confirmed with cervical MRI and MRA.
Keywords
Aged, Angiography/methods, Carotid Artery, Internal/pathology, Carotid Artery, Internal, Dissection/diagnosis, Carotid Artery, Internal, Dissection/pathology, Carotid Stenosis, Cerebral Angiography, False Positive Reactions, Humans, Ischemia/diagnosis, Ischemia/pathology, Magnetic Resonance Angiography/methods, Magnetic Resonance Imaging/methods, Middle Aged, Prospective Studies, Reproducibility of Results, Sensitivity and Specificity, Time Factors, Tomography, X-Ray Computed, Ultrasonography, Doppler, Color/methods
Pubmed
Web of science
Open Access
Yes
Create date
08/10/2012 10:26
Last modification date
20/08/2019 16:05
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