Duplex scanning compared with intra-arterial angiography in diagnosing peripheral arterial disease: three analytical approaches
Duplex scanning compared with intra-arterial angiography in diagnosing peripheral arterial disease: three analytical approaches
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DOI：
10.1024/0301-1526.35.2.86
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发表时间：
2006-05-01
期刊：
影响因子：
--
通讯作者：
Sucic, Z.
中科院分区：
文献类型：
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作者：
Krnic, A.;Vucic, N.;Sucic, Z.
背景：本研究旨在评估与数字减影血管造影相比，双重扫描在诊断下肢外周动脉疾病方面的可靠性。患者和方法：研究了 60 条腿。每条腿分为 5 个动脉段，从主髂动脉到腘动脉。进行了双面扫描和数字减影血管造影。每个节段的疾病被评估为显着或不显着，或根据狭窄程度分为五类（通畅血管或无直径减少、轻度狭窄，即直径减少1-19%、中度和重度狭窄，即直径分别减少20-49%和50-99%、以及闭塞血管）。应用了三种统计方法：计算敏感性和特异性、Kappa 统计和加权 Kappa 值。根据血管造影测量结果，还计算了不同节段动脉狭窄的中位等级。结果：检测显着病变的双重敏感性范围为 0.46 至 0.88。双工和血管造影之间的一致性 Kappa 值范围为 0.35 至 0.64。加权 Kappa 值范围为 0.45 至 0.72。动脉病变的中位等级范围为 2（四分位数范围 1-2）到 4（3-4），并且差异显着（Kruskal-Wallis H 检验，p < 0.001）。结论：敏感性和特异性表明在检测不同下肢节段的显着动脉疾病时存在不同的双重可靠性。一般来说，Kappa 值证明了 duplex 在对狭窄严重程度进行分级方面不够准确。然而，加权 Kappa 值证实了双链体能够更好地估计狭窄程度。动脉段本身受到外周动脉疾病的影响不均匀。
Background: This study was undertaken to assess the reliability of duplex scanning, as compared with digital subtraction angiography, in diagnosing peripheral arterial disease of the lower limbs.Patients and methods: 60 legs were studied. Each leg was divided in 5 arterial segments, from aortoiliac to popliteal. Duplex scanning and digital subtraction angiography were performed. The disease in each segment was assessed as significant or insignificant or classified into five categories concerning the grade of stenosis (patent vessel or no diameter reduction, mild stenosis, i.e. 1-19% diameter reduction, moderate and severe stenosis, i.e. 20-49% and 50-99% diameter reduction, respectively, and occluded vessel). Three statistical approaches were applied: calculating sensitivity and specificity, Kappa statistics, and weighted Kappa value. Median grades of arterial stenosis across different segments, according to angiography measurements, were also calculated.Results: The duplex sensitivity in detecting significant lesions ranged from 0.46 to 0.88. The Kappa values of agreement between duplex and angiography ranged from 0.35 to 0.64. Weighted Kappa values ranged from 0.45 to 0.72. Median grades of arterial lesions ranged from 2 (interquartile range 1-2) to 4 (3-4) and differed significantly (Kruskal-Wallis H test, p < 0.001).Conclusions: The sensitivities and specificities suggested various duplex reliabilities in detecting significant arterial disease across different lower limbs segments. The Kappa values, in general, testified duplex's insufficient accuracy in grading the severity of stenosis. However, weighted Kappa values confirmed duplex's better ability to approximate the grade of stenosis. The arterial segments themselves were unevenly affected with the peripheral arterial disease.