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

Kristian Barlinn, Thomas Floegel, Hagen H. Kitzler, Jessica Kepplinger, Timo Siepmann, Lars Peder Pallesen, Ulf Bodechtel, Heinz Reichmann, Andrei Alexandrov, Volker Puetz

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 (rs = 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.

Original languageEnglish (US)
Pages (from-to)845-851
Number of pages7
JournalNeuroradiology
Volume58
Issue number9
DOIs
StatePublished - Sep 1 2016

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Internal Carotid Artery
Ultrasonography
Brain Ischemia
Pathologic Constriction
Carotid Endarterectomy
Carotid Stenosis
National Institutes of Health (U.S.)
Computed Tomography Angiography
Stroke
Medicine

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Barlinn, K., Floegel, T., Kitzler, H. H., Kepplinger, J., Siepmann, T., Pallesen, L. P., ... Puetz, V. (2016). Multi-parametric ultrasound criteria for internal carotid artery disease—comparison with CT angiography. Neuroradiology, 58(9), 845-851. https://doi.org/10.1007/s00234-016-1706-x

Multi-parametric ultrasound criteria for internal carotid artery disease—comparison with CT angiography. / Barlinn, Kristian; Floegel, Thomas; Kitzler, Hagen H.; Kepplinger, Jessica; Siepmann, Timo; Pallesen, Lars Peder; Bodechtel, Ulf; Reichmann, Heinz; Alexandrov, Andrei; Puetz, Volker.

In: Neuroradiology, Vol. 58, No. 9, 01.09.2016, p. 845-851.

Research output: Contribution to journalArticle

Barlinn, K, Floegel, T, Kitzler, HH, Kepplinger, J, Siepmann, T, Pallesen, LP, Bodechtel, U, Reichmann, H, Alexandrov, A & Puetz, V 2016, 'Multi-parametric ultrasound criteria for internal carotid artery disease—comparison with CT angiography', Neuroradiology, vol. 58, no. 9, pp. 845-851. https://doi.org/10.1007/s00234-016-1706-x
Barlinn K, Floegel T, Kitzler HH, Kepplinger J, Siepmann T, Pallesen LP et al. Multi-parametric ultrasound criteria for internal carotid artery disease—comparison with CT angiography. Neuroradiology. 2016 Sep 1;58(9):845-851. https://doi.org/10.1007/s00234-016-1706-x
Barlinn, Kristian ; Floegel, Thomas ; Kitzler, Hagen H. ; Kepplinger, Jessica ; Siepmann, Timo ; Pallesen, Lars Peder ; Bodechtel, Ulf ; Reichmann, Heinz ; Alexandrov, Andrei ; Puetz, Volker. / Multi-parametric ultrasound criteria for internal carotid artery disease—comparison with CT angiography. In: Neuroradiology. 2016 ; Vol. 58, No. 9. pp. 845-851.
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AU - Siepmann, Timo

AU - Pallesen, Lars Peder

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N2 - 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 (rs = 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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