scholarly journals The Value of Carotid Doppler Ultrasound in Asymptomatic Extracranial Arterial Disease

Author(s):  
Natan M. Bornstein ◽  
Lorraine G. Chadwick ◽  
John W. Norris

ABSTRACT:Carotid Doppler is an accurate, safe and repeatable method of assessing arterial calibre, for distinguishing harmless neck bruits and to identify the stroke prone individual. It is completely non-invasive and can be used serially to monitor progression in carotid stenosis. It is a valuable clinical tool in diagnosis and management in patients at risk of stroke, but has definite limitations, such as in differentiating carotid occlusion from severe stenosis. B-mode imaging, although valuable in identifying arterial anatomy, and detecting plaques, cannot accurately evaluate the degree of stenosis. It is of limited value in identifying plaque hemorrhage and ulceration. Doppler ultrasound technology has advanced rapidly in the last decade, especially in the combination of B-mode imaging and Doppler (Duplex), as well as in evaluating of the intracranial circulation (transcranial Doppler). In the next decade, it may become the new gold standard for evaluating the extracranial and intracranial circulation.

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 341-348 ◽  
Author(s):  
Marc Husmann ◽  
Vincenzo Jacomella ◽  
Christoph Thalhammer ◽  
Beatrice R. Amann-Vesti

Abstract. Increased arterial stiffness results from reduced elasticity of the arterial wall and is an independent predictor for cardiovascular risk. The gold standard for assessment of arterial stiffness is the carotid-femoral pulse wave velocity. Other parameters such as central aortic pulse pressure and aortic augmentation index are indirect, surrogate markers of arterial stiffness, but provide additional information on the characteristics of wave reflection. Peripheral arterial disease (PAD) is characterised by its association with systolic hypertension, increased arterial stiffness, disturbed wave reflexion and prognosis depending on ankle-brachial pressure index. This review summarises the physiology of pulse wave propagation and reflection and its changes due to aging and atherosclerosis. We discuss different non-invasive assessment techniques and highlight the importance of the understanding of arterial pulse wave analysis for each vascular specialist and primary care physician alike in the context of PAD.


1982 ◽  
Vol 47 (02) ◽  
pp. 141-144 ◽  
Author(s):  
H Bounameaux ◽  
B Krähenbühl ◽  
S Vukanovic

SummaryDoppler ultrasound flow examination, strain gauge plethysmography and contrast venography were performed in 160 lower limbs of 80 in-patients. Deep vein thrombosis (DVT) was suspected in 87 limbs. Using measurement of venous stop-flow pressure, the Doppler method had an overall sensitivity of 83%. By combined use of Doppler and Plethysmography, sensitivity was increased to 96%. Specificity was 62% and 51%, respectively. With a positive and a negative predictive value of 80% and 73%, respectively, the combination of both non-invasive methods cannot reliably replace venography in the diagnosis of DTV, although all (40/40) thromboses proximal to or involving the popliteal segment were detected by either Doppler and Plethysmography or both.After exclusion of 14 patients (18%) suffering from conditions known to alter the results of these non-invasive methods, the positive predictive value of abnormal findings in both Doppler and Plethysmography was increased to 94% for suspected limbs, whilst negative predictive value of both negative Doppler and Plethysmography was 90%, allowing the avoidance of venography in these patients.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Katarzyna Sołkiewicz ◽  
Hubert Krotkiewski ◽  
Marcin Jędryka ◽  
Ewa M. Kratz

AbstractEndometriosis is an inflammatory disease which diagnostics is difficult and often invasive, therefore non-invasive diagnostics methods and parameters are needed for endometriosis detection. The aim of our study was to analyse the glycosylation of native serum IgG and IgG isolated from sera of women classified as: with endometriosis, without endometriosis but with some benign ginecological disease, and control group of healthy women, in context of its utility for differentiation of advanced endometriosis from the group of healthy women. IgG sialylation and galactosylation/agalactosylation degree was determined using specific lectins: MAA and SNA detecting sialic acid α2,3- and α2,6-linked, respectively, RCA-I and GSL-II specific to terminal Gal and terminal GlcNAc, respectively. The results of ROC and cluster analysis showed that the serum IgG MAA-reactivity, sialylation and agalactosylation factor may be used as supplementary parameters for endometriosis diagnostics and could be taken into account as a useful clinical tool to elucidate women with high risk of endometriosis development. Additionally, we have shown that the analysis of native serum IgG glycosylation, without the prior time-consuming and expensive isolation of the protein, is sufficient to differentiation endometriosis from a group of healthy women.


Author(s):  
Patrick Veit-Haibach ◽  
Martin W. Huellner ◽  
Martin Banyai ◽  
Sebastian Mafeld ◽  
Johannes Heverhagen ◽  
...  

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.


2021 ◽  
pp. 154431672110303
Author(s):  
Sayan Sarkar ◽  
Shyam Mohan ◽  
Shakthi Parvathy

The purpose of this study is to analyze how accurate duplex ultrasonography using color Doppler and computed tomography (CT) angiography are in detection of peripheral arterial disease (PAD) in comparison with the Gold Standard of digital subtraction angiography (DSA). This is a single-center prospective, analytical study done on patients with symptoms of PAD referred to the Department of Radiodiagnosis of Medical Trust Hospital (n = 53). All patients were imaged with color Doppler, CT angiography, and DSA. The peak systolic velocity (PSV) ratio was calculated by Doppler ultrasound, and the percentage stenosis for the same vascular segments was calculated using CT angiography and DSA. To test the statistical significance between the results, chi-square test was used. A P value <.05 indicates statistical significance. The PSV ratio for each grade—normal (<1.5), mild (1.5-2.8), moderate (2.9-4.9), and severe (≥5)—and the percentage of stenosis for each grade observed on CT angiography—normal (<20% stenosis), mild (20%-49% stenosis), moderate (50%-74% stenosis), severe (75%-99% stenosis), and total occlusion (100% stenosis)—were found to be highly sensitive and specific with good positive predictive value, negative predictive value, and accuracy level when compared with DSA with narrow confidence intervals for each range. The P value was <.001 for both color Doppler and CT angiography. Computed tomography angiography can be an effective tool as an alternative to DSA for gradation of stenosis if the artifacts resulting from vascular calcification can be avoided. Duplex ultrasonography can be utilized for gradation of stenosis by using the value of PSV ratio and spectral pattern together. However, it can only act as an adjunct to CT angiography because it is incapable of imaging the full length of the arterial segments in 1 frame.


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