A prospective comparison of lower limb colour-coded Duplex scanning with arteriography

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Radiology

Background:

• Arterial disease in the lower limbs significantly impacts patient mobility and quality of life.
• Accurate diagnosis is crucial for effective treatment planning and intervention.
• Traditional arteriography is invasive, while non-invasive imaging modalities are continuously evaluated.

Purpose of the Study:

• To compare the diagnostic accuracy of color Duplex scanning against arteriography.
• To assess the detection of arterial disease in the aortoiliac, femoropopliteal, and tibial arteries.
• To evaluate the agreement between these two imaging techniques.

Main Methods:

• A prospective, semi-blind study involving 148 limbs (1658 arterial segments).
• Comparison of color Duplex scanning and digital subtraction arteriography.
• Classification of arterial segments based on stenosis severity (0-49%, 50-99%, occluded) using peak systolic velocity ratios and Doppler signals.
• Statistical analysis using Kappa (k) to determine agreement between modalities.

Main Results:

• Overall substantial agreement between color Duplex scanning and arteriography (kappa = 0.74).
• Substantial agreement in femoropopliteal arteries (kappa = 0.80).
• Moderate agreement in aortoiliac (kappa = 0.59) and infrapopliteal arteries (kappa = 0.48).

Conclusions:

• Color Duplex scanning demonstrates substantial agreement with arteriography for lower limb arterial disease.
• The findings support color Duplex scanning as a valuable diagnostic tool.
• Further investigation is warranted to explore the role of color Duplex scanning in guiding vascular interventions.