Accuracy of the Society of Radiologists in Ultrasound (SRU) Carotid Doppler Velocity Criteria for Grading North American Symptomatic Carotid Endarterectomy Trial (NASCET) Stenosis: A Meta-Analysis.
Accuracy of the Society of Radiologists in Ultrasound (SRU) Carotid Doppler Velocity Criteria for Grading North American Symptomatic Carotid Endarterectomy Trial (NASCET) Stenosis: A Meta-Analysis.
复制标题
超声放射科医生协会 (SRU) 颈动脉多普勒速度标准对北美症状性颈动脉内膜切除术试验 (NASCET) 狭窄分级的准确性：荟萃分析。
DOI：
10.1002/jum.16150
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Alexandrov,AndreiV
中科院分区：
文献类型：
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作者：
Polak,JosephF;Alexandrov,AndreiV
目的超声放射医师协会（SRU）共识小组根据北美症状性颈动脉内膜切除术试验（NASCET）方法提出了6个多普勒速度分界点，用于颈内动脉（伊卡）狭窄50%和70%的分类。他们的相对准确性还没有compared.Materials and MethodsMeta-analysis进行全面的文献综述和识别的手稿与图表的个别患者NASET伊卡狭窄测量动脉造影与伊卡收缩期峰值流速（PSV），舒张末期流速（EDV）和伊卡PSV颈总动脉（CCA）PSV。计算真阳性、真阴性、假阳性和假阴性，并用于两水平混合效应模型。生成分层汇总受试者工作特征（ROC）曲线。ROC曲线下面积estimated.ResultsNine研究1993年和2016年之间进行了337手稿审查后确定。共提取了1738个PSV分叉数据点、1026个EDV分叉数据点和775个伊卡/CCA分叉数据点。PSV为125 cm/s（50%狭窄）时的最高敏感性为96%（95% CI：93%，98%），PSV为230 cm/s（70%狭窄）时的最高特异性为86%（95% CI：71%，93%）。ROC曲线下面积范围从PSV（50%狭窄）的0.93（95%CI：0.92，0.95）到EDV（70%狭窄）的0.86（95%CI：0.84，0.88）。PSV临界点具有权衡：50%狭窄的高灵敏度/低特异性和70%狭窄的高特异性/中等灵敏度。
PurposeThe Society of Radiologists in Ultrasound (SRU) consensus panel proposed six Doppler velocity cut points for classifying internal carotid artery (ICA) stenosis of 50% and 70% according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method. Their relative accuracies have not been compared.Materials and MethodsMeta‐analysis performed following comprehensive literature review and identification of manuscripts with graphs of individual patient NASCET ICA stenosis measured by arteriography versus ICA peak‐systolic velocity (PSV), end‐diastolic velocity (EDV) and ICA PSV to common carotid artery (CCA) PSV. True positives, true negatives, false positives, and false negatives were calculated and used in two‐level mixed effects models. Hierarchical summary receiver operating characteristic (ROC) curves were generated. Areas under the ROC curves were estimated.ResultsNine studies performed between 1993 and 2016 were identified after review of 337 manuscripts. There were 1738 bifurcation data points extracted for PSV, 1026 for EDV, and 775 for ICA/CCA ratio. The highest sensitivity was 96% (95% CI: 93%, 98%) for PSV of 125 cm/s (50% stenosis) and highest specificity 86% (95% CI: 71%, 93%) for PSV of 230 cm/s (70% stenosis). Areas under the ROC curves ranged from a high of 0.93 (95% CI: 0.92, 0.95) for PSV (50% stenosis) to a low of 0.86 (95% CI: 0.84, 0.88) for EDV (70% stenosis).ConclusionsThe SRU consensus Doppler cut points vary in their accuracies for predicting ICA stenosis. The PSV cut points have tradeoffs: high sensitivity/low specificity for 50% stenosis and high specificity/moderate sensitivity for 70% stenosis.