Is B-mode ultrasound alone a sufficient screening tool for carotid stenosis? A pilot study

被引:3
作者
Bhandari T. [1 ]
Socransky S.J. [2 ]
机构
[1] Emergency Department, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, M4N 3M5, ON
[2] Emergency Department, Health Sciences North, 41 Ramsey Lake Road, Sudbury, P3E 5J1, ON
关键词
Carotid stenosis; Doppler ultrasonography; Duplex ultrasonography; Point-of-care ultrasonography; Ultrasonography;
D O I
10.1186/s13089-014-0017-x
中图分类号
学科分类号
摘要
Background: Carotid ultrasound is performed solely in hospital ultrasound departments or outpatient labs, using both B- and Doppler modes. We hypothesize that B-mode without Doppler can be used to classify patients as having carotid stenosis (CS) above or below 50%. Our objective is to determine the frequency with which a CS >50% is found using Doppler when no such stenosis was visible using B-mode.; Methods: This was a retrospective study of 100 patients referred to the stroke clinic and 100 patients referred for carotid endarterectomy (CEA). All patients had an elective carotid ultrasound done at Health Sciences North. The ultrasound reports were mixed together and blinded. Investigators determined if there was a CS of greater or less than 50% based on the carotid diagram. These results were compared to the degree of CS found on Doppler.; Conclusion: This study supports the theory that it may be possible to use B-mode ultrasound without Doppler to reliably determine if there is CS above or below 50%. Further research is required before carotid ultrasound using B-mode alone can be recommended.; Results: In the CEA group, there were 198 ultrasounds, with 153 showing a CS of >50%. Only one case of CS >50% was missed by B-mode. In the clinic group, 32 of 192 ultrasounds showed a CS of >50%. None were missed by B-mode. B-mode had a sensitivity and negative predictive value of 100% and a specificity of 65%. © 2014, Bhandari and Socransky; licensee Springer.
引用
收藏
页数:5
相关论文
共 10 条
[1]  
Acerra J.R., Iskyan K., Qureshi Z.A., Sharma R.K., Rebuilding the health care system in Afghanistan: an overview of primary care and emergency services, Int J Emerg Med, 2, 2, pp. 77-82, (2009)
[2]  
Feigin V.L., Lawes C.M.M., Bennett D.A., Barker-Collo S.L., Parag V., Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review, Lancet Neurol, 8, pp. 355-369, (2009)
[3]  
North American Symptomatic Carotid Endarterectomy Trial Collaborators, Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade stenosis, N Engl J Med, 325, pp. 445-453, (1991)
[4]  
Rahimzai M., Amiri M., Burhani N.H., Leatherman S., Hiltebeitel S., Rahmanzai A.J., Afghanistan’s national strategy for improving quality in health care, Int J Qual Health Care, 25, 3, pp. 270-276, (2013)
[5]  
Franco L.M., Marquez L., Effectiveness of collaborative improvement: evidence from 27 applications in 12 less developed and middle-income countries, BMJ Qual Saf, 20, pp. 658-665, (2011)
[6]  
Lavenson G.S., The American Vascular Association Screening Program: rationale, method, guidelines and progress, J Vasc Ultrasound, 29, pp. 85-89, (2005)
[7]  
Wolff T., Guirguis-Blake J., Miller T., Gillespie M., Harris R., Screening for asymptomatic carotid artery stenosis. Evidence synthesis No. 50. AHRQ publication No. 08-05102-EF-1, (2007)
[8]  
Campbell J., Buchan J., Cometto G., David B., Dussault G., Fogstad H., Fronteira I., Lozano R., Nyonator F., Pablos-Mendez A., Quian E.E., Starrs A., Tangcharoensathien V., Human resources for health and universal health coverage: fostering equity and effective coverage, Bull World Health Organ, 91, pp. 853-863, (2013)
[9]  
Ratchford E.V., Jin Z., Di Tullio M.R., Salameh M.J., Homma S., Gan R., Boden-Albala B., Sacco R.L., Rundek T., Carotid bruit for detection of hemodynamically significant carotid stenosis: the Northern Manhattan study, Neurol Res, 31, pp. 748-752, (2009)
[10]  
Ray A., Tamsma J.T., Hovens M.M.C., Roodt J., Huisman M.V., Accuracy of carotid plaque detection and intima-media thickness measurement with ultrasonography in routine clinical practice, Eur J Intern Med, 21, pp. 35-39, (2010)