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Multi-parametric ultrasound criteria for internal carotid artery disease—comparison with CT angiography

  • Diagnostic Neuroradiology
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Abstract

Introduction

The German Society of Ultrasound in Medicine (known by its acronym DEGUM) recently proposed a novel multi-parametric ultrasound approach for comprehensive and accurate assessment of extracranial internal carotid artery (ICA) steno-occlusive disease. We determined the agreement between duplex ultrasonography (DUS) interpreted by the DEGUM criteria and CT angiography (CTA) for grading of extracranial ICA steno-occlusive disease.

Methods

Consecutive patients with acute cerebral ischemia underwent DUS and CTA. Internal carotid artery stenosis was graded according to the DEGUM-recommended criteria for DUS. Independent readers manually performed North American Symptomatic Carotid Endarterectomy Trial-type measurements on axial CTA source images. Both modalities were compared using Spearman’s correlation and Bland-Altman analyses.

Results

A total of 303 acute cerebral ischemia patients (mean age, 72 ± 12 years; 58 % men; median baseline National Institutes of Health Stroke Scale score, 4 [interquartile range 7]) provided 593 DUS and CTA vessel pairs for comparison. There was a positive correlation between DUS and CTA (r s  = 0.783, p < 0.001) with mean difference in degree of stenosis measurement of 3.57 %. Bland-Altman analysis further revealed widely varying differences (95 % limits of agreement −29.26 to 22.84) between the two modalities.

Conclusion

Although the novel DEGUM criteria showed overall good agreement between DUS and CTA across all stenosis ranges, potential for wide incongruence with CTA underscores the need for local laboratory validation to avoid false screening results.

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Authors and Affiliations

  1. Department of Neurology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany

    Kristian Barlinn, Thomas Floegel, Jessica Kepplinger, Timo Siepmann, Lars-Peder Pallesen, Ulf Bodechtel, Heinz Reichmann & Volker Puetz

  2. Department of Neuroradiology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany

    Thomas Floegel & Hagen H. Kitzler

  3. Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN, USA

    Andrei V. Alexandrov

Authors
  1. Kristian Barlinn
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  2. Thomas Floegel
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  3. Hagen H. Kitzler
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  4. Jessica Kepplinger
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  5. Timo Siepmann
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  6. Lars-Peder Pallesen
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  8. Heinz Reichmann
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  9. Andrei V. Alexandrov
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  10. Volker Puetz
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Corresponding author

Correspondence to Kristian Barlinn.

Ethics declarations

We declare that all human and animal studies have been approved by the ethics committee of the Technische Universität Dresden (#111032014) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Due to the retrospective nature of this study, informed consent was waived.

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We declare that we have no conflict of interest.

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Barlinn, K., Floegel, T., Kitzler, H.H. et al. Multi-parametric ultrasound criteria for internal carotid artery disease—comparison with CT angiography. Neuroradiology 58, 845–851 (2016). https://doi.org/10.1007/s00234-016-1706-x

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  • DOI: https://doi.org/10.1007/s00234-016-1706-x

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