[Diagnostic evaluation of quantitative analyses of 0-crossing velocity wave for the peripheral arterial occlusive...

Diagnostic reliability of 0-crossing velocity wave obtained by Doppler flow meter was evaluated both clinically and experimentally for peripheral arterial occlusive disease. Among seven indices evaluated as to their diagnostic ability, Pulsatility index (P.I.), proximal damping quotient (PDQ) and peak forward velocity (PFV) related with the changes of 0-crossing velocity wave form more closely. Therefore, these three parameters are thought to be suitable for further analyses. Either of these three indices (P.I., PDQ and PFV) revealed good correlation with severity of proximal occlusive disease but was also affected by distal run-off by some degree. P.I. was most affected by distal resistance and PDQ least affected. Diagnostic sensitivity and specificity were 93.2% and 80.4% in PDQ, 85.7% and 78.4% in P.I. and 84.0% and 82.0% in PFV. Normal values of common femoral indices were: P.I. greater than 4.5, PDQ less than 1.4 and PFV greater than 20 cm/sec. An increase of diagnostic sensitivity and specificity for aortoiliac occlusive disease was obtained by a combined use of P.I., PDQ and PFV: 94% in sensitivity and 89% in specificity. Damping factors of P.I. and PDQ were also valuable for localizing the distal occlusive disease below femoral artery.