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Peripheral ischemic occlusive arterial disease: comparison of color Doppler sonography and angiography
F Pinto1, R Lencioni, V Napoli
1Department of Radiology, University of Pisa, Italy.
Insights
Color Doppler sonography accurately evaluates peripheral ischemic disease, showing high agreement with angiography in identifying nonsignificant stenoses, significant stenoses, and occlusions. This noninvasive method is reliable for patient assessment.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
Background:
- Peripheral ischemic disease significantly impacts patient mobility and quality of life.
- Accurate noninvasive diagnostic methods are crucial for managing advanced peripheral ischemic disease.
Purpose of the Study:
- To assess the diagnostic accuracy of color Doppler sonography compared to angiography in evaluating peripheral ischemic disease.
- To determine the agreement between color Doppler sonography and angiography in identifying various types of arterial lesions.
Main Methods:
- A study involving 167 patients with advanced peripheral ischemic disease.
- Examination of 334 legs using both color Doppler sonography and conventional angiography.
- Analysis of 714 arterial lesions, including nonsignificant stenoses, significant stenoses, and occlusions.
Main Results:
- Color Doppler sonography demonstrated a high overall diagnostic agreement of 93.5% with angiography.
- Specific agreement rates were 92.9% for nonsignificant stenoses, 93.9% for significant stenoses, and 95.8% for occlusions.
- Peak systolic velocity ratio showed a stronger correlation with diameter reduction percentage than peak systolic velocity.
Conclusions:
- Color Doppler sonography is a highly accurate noninvasive tool for evaluating peripheral ischemic disease.
- The findings support the routine use of color Doppler sonography in the clinical assessment of these patients.
- This method offers reliable detection and characterization of arterial lesions contributing to ischemia.
Abstract:
We examined 334 legs in 167 consecutive patients with advanced peripheral ischemic disease using color Doppler sonography and angiography. Angiography revealed 714 lesions (369 nonsignificant stenoses, 297 significant stenoses, and 48 occlusions) in the 334 legs examined. Overall, color Doppler sonography revealed diagnostic agreement with angiography in 668 of 714 lesions (93.5%), including 343 of 369 (92.9%) nonsignificant stenoses, 279 of 297 (93.9%) significant stenoses, and 46 of 48 (95.8%) occlusions. Overestimation occurred in 26 of 369 (7%) nonsignificant stenoses and 3 of 297 (1%) significant stenoses. Underestimation was observed in 15 of 297 (5%) significant stenoses and in 2 of 48 (4.2%) occlusions. Peak systolic velocity ratio correlated better (P < 0.01) than peak systolic velocity with diameter reduction percentage as assessed at angiography. Color Doppler sonography is an accurate noninvasive method for evaluating patients with peripheral ischemic disease.