Power Doppler Imaging: Initial Evaluation as a Screening Examination for Carotid Artery Stenosis
Autor: | Michael A. Sullivan, James B. Lyons, Craig A. Beam, Dana Smetherman, Lauren Althans-Kopecky, Harvey L. Neiman, Jonathan H. Sunshine, Philip E. Crewson, Paul A. Heidenreich, Laurie Troxclair, Edward I. Bluth, Jeffrey H. Burkhardt |
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Rok vydání: | 2000 |
Předmět: |
Adult
Male medicine.medical_specialty Cost-Benefit Analysis Carotid arteries Pilot Projects Sensitivity and Specificity Screening Examination Teaching hospital Power doppler medicine Humans Carotid Stenosis Radiology Nuclear Medicine and imaging Prospective Studies Ultrasonography Doppler Color Aged Aged 80 and over medicine.diagnostic_test Receiver operating characteristic business.industry Reproducibility of Results Digital subtraction angiography Middle Aged medicine.disease Transcranial Doppler Stenosis Carotid Artery External cardiovascular system Female Radiology business Carotid Artery Internal |
Zdroj: | Radiology. 215:791-800 |
ISSN: | 1527-1315 0033-8419 |
Popis: | To evaluate power Doppler imaging as a possible screening examination for carotid artery stenosis.In the principal pilot study, a prospective, blinded comparison of power Doppler imaging with duplex Doppler imaging, the reference-standard method, was conducted in 100 consecutive patients routinely referred for carotid artery imaging at a large, private multispecialty clinic. In the validation pilot study, a prospective, blinded comparison of power Doppler imaging with digital subtraction angiography, the reference-standard method, was conducted in 20 consecutive patients routinely referred at a teaching hospital. Using conservative assumptions, the authors performed cost-effectiveness analysis.Power Doppler imaging produced diagnostic-quality images in 89% of patients. When the images of the patients with nondiagnostic examinations were regarded as positive, power Doppler imaging had an area under the receiver operating characteristic curve, A(z), of 0.87, sensitivity of 70%, and specificity of 91%. The validation study results were very similar. The cost-effectiveness of screening and, as indicated, duplex Doppler imaging as the definitive diagnostic examination and endarterectomy was $47,000 per quality-adjusted life-year.The A(z) value for power Doppler imaging compares well with that for mammography, a generally accepted screening examination, and with most other imaging examinations. Power Doppler imaging is likely to be a reasonably accurate and cost-effective screening examination for carotid artery stenosis in asymptomatic populations. |
Databáze: | OpenAIRE |
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