Assurance of consistent peak-velocity measurements with a variety of duplex Doppler instruments.

Kimme-Smith, Carolyn; Hussain, R; Duerinckx, A. J.; Tessler, Franklin N.; Grant, Edward G.

doi:10.1148/radiology.177.1.2204967

Cited by 41 publications

(31 citation statements)

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“…12,14,15 Additionally, changes within the ultrasound machine (ie, upgrades) can contribute to the variability in thresholds. [21][22][23][24] Two major changes occurred in addition to several other software upgrades in the past years. The 7-4 MHz broadband linear array transducer became available in between the first period and the second period (1995), which improved the visualization of the carotid bifurcation remarkably and hence facilitated the acquisition of the PSV ICA at the point of the greatest mean frequency shift.…”

Section: Discussionmentioning

confidence: 99%

Changes Over Time in Optimal Duplex Threshold for the Identification of Patients Eligible for Carotid Endarterectomy

Elgersma

Leersum

Buijs

et al. 1998

Stroke

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Background and Purpose-Two surgical trials established that carotid endarterectomy is beneficial to symptomatic patients who have a severe internal carotid artery (ICA) stenosis on angiograms. Duplex ultrasonography-derived hemodynamic parameters show a good correlation with angiography and are often used for detecting severe ICA stenoses. However, duplex performance is ultrasound machine and operator dependent. Over time both may change, possibly affecting duplex performance. We compared duplex performance of 2 time periods in 1 specific vascular laboratory using angiography as the gold standard. Methods-Consecutive patients who underwent both angiography and duplex examinations of the ICA were evaluated (first period, 60 patients; second period, 61 patients). Peak systolic velocity and several other hemodynamic parameters and ratios were analyzed by receiver operating characteristic curves in their ability to detect severe ICA stenoses. The optimal parameter and threshold were determined for each period. Subsequently, duplex test characteristics were compared after the optimal thresholds of both the first and the second periods were applied in the second period. Results-In both periods peak systolic velocity of the ICA was the best test parameter; areas under the receiver operating characteristic curve were similar (0.957 and 0.954, respectively). However, the optimal threshold was different. The optimal threshold in the second period was 270 cm/s. When the optimal threshold of 210 cm/s of the first period was applied in the second period, test characteristics changed significantly. Sensitivity increased from 98% to 100%, and specificity decreased from 85% to 71% (Pϭ0.004). Conclusions-The optimal threshold for detecting severe ICA stenoses with duplex ultrasonography in our laboratory changed over time. Individual laboratories should assess duplex accuracy regularly and adjust adopted criteria if necessary to keep diagnostic performance optimal.

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Section: Discussionmentioning

confidence: 99%

Changes Over Time in Optimal Duplex Threshold for the Identification of Patients Eligible for Carotid Endarterectomy

Elgersma

Leersum

Buijs

et al. 1998

Stroke

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“…Even though we had accepted the possibility of fi nding differences in hemodynamic variables (due to the fact that different measuring instruments were used [11] ) after a perceptive statistical study, the information obtained with CVI showed that for supratesticular and parenchymal arteries, the parameters of the young and healthy subjects of our sample coincided with the parameters of those subjects of a similar age who suffered from an inguinal hernia. The hemodynamic map was confi rmed in these territories, although it was necessary to resort to a selection of subjects with an age limit of 30.…”

Section: Discussionmentioning

confidence: 88%

Testicular-Epididymal Hemodynamics and Inguinal Hernia

et al. 2005

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Testicular-epididymal hemodynamics is studied by ultrasonographic color velocity imaging (CVI) in patients with primary, uncomplicated inguinal hernias. This procedure allows more precision than any other known Doppler system in measuring hemodynamic parameters such as peak systolic and diastolic velocity, resistance index and pulsatility index. The results of the exploration of 480 arteries of various testicular vascular territories are compared with those obtained by other authors in young healthy individuals using color Doppler. This procedure shows that the hernia does not cause significant alterations in the arterial circulation of the testicle and epididymis.

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“…The wide variety of commercially available duplex Doppler systems which have not been properly calibrated has led to inconsistency of quantitative data. Measurements of peak velocities obtained using 17 different Doppler ultrasound machines were compared, with values obtained from calibrated phantoms 24. The variation among the various systems averaged 23% under identical conditions.…”

Section: In‐vitro In‐vivo Reproducibility Testsmentioning

confidence: 99%

The detection of occult liver metastases of colorectal carcinoma

Leen

1999

Journal of Hepato-Biliary-Pancreatic Surgery

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Despite undergoing an apparently curative surgery, over 50% of colorectal cancer patients will die within 5 years, the majority within the first 2 years from disseminated disease. Occult liver metastases are reported to be present in approximately 30% of patients and they predominantly determine the likelihood of dying from disseminated disease. The question is how to detect these occult hepatic metastases. This article reviews some of the alternative techniques, such as dynamic scintigraphy, functional computerized tomography, and duplex colour Doppler sonography (DCDS), which have been developed to predict which patients harbor these occult metastases. More recently, DCDS measurements of the Doppler perfusion index (DPI: ratio of hepatic arterial to total liver blood flow) have been shown to be highly accurate in the detection of these occult liver metastases. In addition, irrespective of Dukes stage, patients with abnormal DPI were shown to have a very poor outcome while for those with normal DPI, the prognosis was excellent. If the data are reproduced, the administration of adjuvant chemotherapy should be based on DPI status rather than Dukes stage.

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Assurance of consistent peak-velocity measurements with a variety of duplex Doppler instruments.

Cited by 41 publications

References 0 publications

Changes Over Time in Optimal Duplex Threshold for the Identification of Patients Eligible for Carotid Endarterectomy

Changes Over Time in Optimal Duplex Threshold for the Identification of Patients Eligible for Carotid Endarterectomy

Testicular-Epididymal Hemodynamics and Inguinal Hernia

The detection of occult liver metastases of colorectal carcinoma

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