Reliability of doppler ultrasound in follow-up studies

Mikkonen, Raija; Kreula, J; Virkkunen, Pekka

doi:10.1080/02841859809172178

Cited by 25 publications

(14 citation statements)

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“…Improvements of diagnostic tools such as duplex ultrasound, magnetic resonance tomography angiography, and multislice computed tomography angiography have lead to a more frequent diagnosis of renal artery stenosis during the last decade. [29][30][31][32][33][34][35][36][37][38][39][40][41] The cheapest and easiest to handle diagnostic tool is color duplex ultrasound. However, the accuracy of this method depends on the skill of the physician and the quality of the duplex machine 33 and is furthermore limited by not uniformly defined criteria for the detection of a hemodynamically relevant renal artery stenosis, e.g., a diameter stenosis of at least 70%.…”

Section: Diagnosis Of Renal Artery Stenosismentioning

confidence: 99%

“…However, the accuracy of this method depends on the skill of the physician and the quality of the duplex machine 33 and is furthermore limited by not uniformly defined criteria for the detection of a hemodynamically relevant renal artery stenosis, e.g., a diameter stenosis of at least 70%. [32][33][34][35][36][37][38][39][40][41] The most specific parameter to detect a renal artery stenosis of at least 70% is a side difference of the intrarenal resistance index according to Pourcelot of at least 0.05 with a specificity of up to 100%. 32,35,39 It has been shown that serial duplex ultrasound examination during follow-up after primarily successful stent angioplasty of renal artery stenosis is able to detect restenosis with a high accuracy.…”

Section: Diagnosis Of Renal Artery Stenosismentioning

confidence: 99%

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Renal Artery Stenosis: Epidemiology, Clinical Manifestation, and Percutaneous Endovascular Therapy

Zeller¹

2005

J Interven Cardiology

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Renal artery stenosis may cause or deteriorate arterial hypertension and/or renal insufficiency. Technical improvements of diagnostic and interventional endovascular tools have lead to a more widespread use of endoluminal renal artery revascularization and extension of the indications for this type of therapy. Since the first renal artery angioplasties performed by Felix Mahler and Andreas Grüntzig in 1978, numerous single-center studies have reported the beneficial effect of percutaneous transluminal renal angioplasty, and since the early 1990's stenting of renal artery stenosis caused either by atherosclerosis or by fibromuscular dysplasia. This article summarizes the impact of technical improvements of endovascular tools on interventional techniques during the last decade and gives an overview concerning the clinical impact of renal artery revascularization. Despite the absence of sufficient randomized studies, there is nonetheless evidence that stenting of hemodynamically relevant atherosclerotic renal artery stenosis has an impact on blood pressure control, renal function, and left ventricular hypertrophy.

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Section: Diagnosis Of Renal Artery Stenosismentioning

confidence: 99%

Section: Diagnosis Of Renal Artery Stenosismentioning

confidence: 99%

Renal Artery Stenosis: Epidemiology, Clinical Manifestation, and Percutaneous Endovascular Therapy

Zeller¹

2005

J Interven Cardiology

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“…False-positive findings at transcranial Doppler US can be a result from poor reliability of velocity measurements and influence of many biologic factors on flow velocities (6)(7)(8)(9)(10). Standardization of transcranial Doppler US procedures among centers is problematic because efforts to reproduce recommended velocity values have shown differences (2,11,12).…”

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confidence: 99%

Sickle Cell Disease: Ratio of Blood Flow Velocity of Intracranial to Extracranial Cerebral Arteries—Initial Experience

et al. 2009

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Purpose:To establish reference values of the ratios of flow velocity in the middle cerebral artery (V MCA ) and the terminal portion of the internal carotid artery (V tICA ) to flow velocity in the extracranial portion of internal carotid artery (V ICA ) in children with sickle cell disease (SCD). Materials and Methods:Institutional ethics committee approval and parental informed consent were obtained for this prospective HIPAAcompliant study. Sixty-eight children (38 female; mean age, 7.7 years Ϯ 3.3; range, 2-14 years) with HbSS genotype, without neurologic deficits and no history of stroke, were enrolled. Final study population comprised 56 (mean age 8.0 Ϯ 3.3 years, 26 females) children who underwent magnetic resonance (MR) angiography, which excluded intracranial arterial narrowing, transcranial color-coded duplex ultrasonography (US), and carotid US to determine V MCA /V ICA and V tICA /V ICA ratios from angle-corrected and uncorrected velocities. Tolerance interval estimates were used to calculate reference ranges and linear regression was used to quantify associations of Doppler parameters with age adjusted for hemoglobin and hematocrit. Results:Reference ranges in centimeters per second for mean angle-corrected V MCA on the left and right sides were 62-198 and 69 -153; those for V tICA were 30 -196 and 36 -175; and those for V ICA were 18 -116 and 15-95, respectively. Reference ranges for mean angle-corrected V MCA /V ICA ratio on the left and right sides were 1.2-4.0 and 0.4 -3.4 and those for V tICA /V ICA ratio were 0.5-2.9 and 0.5-2.7, respectively. V MCA , V tICA , and V tICA /V ICA ratio were not age dependent, contrary to V ICA and V MCA /V ICA ratio, after controlling for hematocrit and hemoglobin. Conclusion:The study provides reference limits for V MCA , V tICA , V ICA , and velocity ratios obtained from children with SCD. Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article. Children with sickle cell disease (SCD) who develop intracranial arterial narrowing are at high risk of stroke (1). Transcranial Doppler ultrasonography (US) is a noninvasive method extensively used to detect narrowing based on flow velocity thresholds (1,2). Chronic transfusions can substantially reduce the risk of stroke in children with high velocities at transcranial Doppler US (1), yet even 70% of patients with high velocity who do not undergo transfusions do not develop stroke (3). Chronic transfusions are costly and associated with substantial morbidity and some mortality from transfusion-related infections, alloimmunization, and hemosiderosis (4,5). Children with high hyperemic velocity due to anemia may not have the same benefits from the transfusion therapy as those with arterial narrowing. Transcranial Doppler US screening should be improved since currently more patients may be exposed to substantial risk than the number that benefit from transfusion.False-po...

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“…Without use of any contrast enhancement, US may be able to act as an alternative to contrast-enhanced MRI (36)(37)(38). Unlike MRI though, US is highly operator dependent and to perform some of the more specialist examinations well (renal Doppler, carotid Doppler), requires specialized training (39)(40)(41). Furthermore, attenuation of the US wave with distance from the probe can make it impossible to gain Doppler information from tissues that lie deep within the body.…”

Section: Alternatives To Mrimentioning

confidence: 99%

NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Nephrogenic Systemic Fibrosis: Non‐Gadolinium Options for the Imaging of CKD/ESRD Patients

Dawson¹,

Punwani²

2008

Seminars in Dialysis

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Nephrogenic systemic fibrosis (NSF) is a severe systemic disorder developing apparently exclusively in patients in advanced renal failure who receive a gadolinium chelate contrast-enhancing agent for magnetic resonance imaging. Some other apparent risk factors have been identified but their status remains uncertain. Physicians are frequently confronted with patients at risk of NSF who need imaging. An approach to planning imaging in patients at risk to develop NSF is outlined.

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Reliability of doppler ultrasound in follow-up studies

Abstract: The short-term and long-term reliability of Doppler US was poor when the measurements were performed by a heterogeneous group of radiologists. The RI and PI measurements were somewhat more reliable than the PSV measurements and are recommended for use in follow-up studies.

Cited by 25 publications

References 0 publications

Renal Artery Stenosis: Epidemiology, Clinical Manifestation, and Percutaneous Endovascular Therapy

Renal Artery Stenosis: Epidemiology, Clinical Manifestation, and Percutaneous Endovascular Therapy

Sickle Cell Disease: Ratio of Blood Flow Velocity of Intracranial to Extracranial Cerebral Arteries—Initial Experience

NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Nephrogenic Systemic Fibrosis: Non‐Gadolinium Options for the Imaging of CKD/ESRD Patients

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