The Correlation of Transcranial Colour ‑⁠ Coded Duplex Sonography, CT Angiography and Digital Subtraction Angiography in Patients with Atherosclerotic Disorders of Cerebral Arteries in Common Clinical Practice

Czech version

Authors: M. Roubec ¹; D. Školoudík ^1,2; R. Herzig ²; M. Bar ¹; T. Jonszta ³; V. Procházka ³; J. Chmelová ³; T. Fadrná ¹; K. Langová ⁴
Authors‘ workplace: Neurologická klinika FN Ostrava ¹; Neurologická klinika LF UP a FN Olomouc ²; Ústav radiodiagnostický FN Ostrava ³; Ústav lékařské biofyziky LF UP v Olomouci ⁴
Published in: Cesk Slov Neurol N 2009; 72/105(6): 542-547
Category: Original Article

Overview

Objectives:
Atherosclerotic affection of cervical and cerebral arteries is one of the most common causes of ischemic stroke. Various neuroimaging

methods may be used in the detection of vascular pathology. The aim of the study was to compare intracranial vessel findings in stroke patients arising out of three different examination methods: transcranial colour-coded sonography (TCCS), CT angiography (CTA) and digital subtraction angiography (DSA) within two months of entering common clinical practice.

Methods:
A single-centre retrospective study was performed. Thirty-five patients fulfilling inclusion criteria were admitted to the study (25 males, 10 females, age 23–79, mean 59.7 ± 12.2 years). All patients were hospitalized in the course of the 12 months (January 2007 through December 2007) and all of them underwent TCCS, CTA and DSA angiography within two months. The internal carotid artery, M1 section of middle cerebral artery (M1), A1 section of anterior cerebral artery and P1 section of posterior cerebral artery (P1) were examined on both sides. Findings were divided into four groups: normal, stenosis < 50%, stenosis 50–99%, and occlusion. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and Cohen’s kappa were statistically evaluated for comparison of the three methods.

Results:
Technical circumstances or insufficient temporal bone window meant that of a total of 280 vessels, 226 were evaluated. Sensitivity, specificity, PPV, NPV of CTA and TCCS in comparison with gold standard DSA were 75.0; 98.6; 80.0; 98.1%, and 81.3; 96.2; 61.9; 98.5%, respectively. Methods were in concordance: CTA and DSA 96.02% (κ = 0.694), TCCS and DSA 94.25% (κ = 0.628), CTA and TCCS 94.25% (κ = 0.619).

Conclusion:
Substantial agreement was established between all three methods. Two of the evaluated methods are sufficient for diagnosis when consenting, when the third method need not be undertaken.

Key words:
stenosis –⁠ occlusion –⁠ transcranial color--coded duplex sonography –⁠ CT angiography –⁠ digital subtraction angiography

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