Keisuke Tokunaga1, Masatoshi Koga2, Sohei Yoshimura1, Shoji Arihiro3, Rieko Suzuki1, Kazuyuki Nagatsuka4, Kazunori Toyoda1. 1. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 2. Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: koga@ncvc.go.jp. 3. Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 4. Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Abstract
BACKGROUND: We aimed to determine the optimal peak systolic velocity (PSV) thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% internal carotid artery (ICA) stenosis. METHODS: Patients who underwent both carotid ultrasonography and cerebral angiography during hospitalization were consecutively and retrospectively enrolled. The degree of ICA stenosis was calculated using the North American Symptomatic Carotid Endarterectomy Trial method on cerebral angiography. The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were determined using receiver operating characteristic curves and the Youden index. RESULTS: A total of 127 ICAs were analyzed. The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were 130 cm/s (sensitivity, 95%; specificity, 85%; positive predictive value [PPV], 75%; negative predictive value [NPV], 97%; overall accuracy, 88%), 160 cm/s (sensitivity, 91%; specificity, 94%; PPV, 83%; NPV, 97%; overall accuracy, 93%), 200 cm/s (sensitivity, 96%; specificity, 95%; PPV, 83%; NPV, 99%; overall accuracy, 95%), and 270 cm/s (sensitivity, 89%; specificity, 94%; PPV, 74%; NPV, 98%; overall accuracy, 94%), respectively. CONCLUSIONS: The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were 130 cm/s, 160 cm/s, 200 cm/s, and 270 cm/s, respectively. All of them had high diagnostic accuracies.
BACKGROUND: We aimed to determine the optimal peak systolic velocity (PSV) thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% internal carotid artery (ICA) stenosis. METHODS:Patients who underwent both carotid ultrasonography and cerebral angiography during hospitalization were consecutively and retrospectively enrolled. The degree of ICA stenosis was calculated using the North American Symptomatic Carotid Endarterectomy Trial method on cerebral angiography. The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were determined using receiver operating characteristic curves and the Youden index. RESULTS: A total of 127 ICAs were analyzed. The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were 130 cm/s (sensitivity, 95%; specificity, 85%; positive predictive value [PPV], 75%; negative predictive value [NPV], 97%; overall accuracy, 88%), 160 cm/s (sensitivity, 91%; specificity, 94%; PPV, 83%; NPV, 97%; overall accuracy, 93%), 200 cm/s (sensitivity, 96%; specificity, 95%; PPV, 83%; NPV, 99%; overall accuracy, 95%), and 270 cm/s (sensitivity, 89%; specificity, 94%; PPV, 74%; NPV, 98%; overall accuracy, 94%), respectively. CONCLUSIONS: The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were 130 cm/s, 160 cm/s, 200 cm/s, and 270 cm/s, respectively. All of them had high diagnostic accuracies.
Authors: Nicolle Cassola; Jose Cc Baptista-Silva; Luis Cu Nakano; Carolina Dq Flumignan; Ricardo Sesso; Vladimir Vasconcelos; Nelson Carvas Junior; Ronald Lg Flumignan Journal: Cochrane Database Syst Rev Date: 2022-07-11