Overestimation of moderate carotid stenosis assessed by both Doppler US and contrast enhanced 3D-MR angiography in the CARMEDAS study.

Michel Nonent; D. Ben Salem; J.-M. Serfaty; V. Buthion; A. Pasco-Papon; C. Rotaru; Luc Bressollette; X. Papon; C. Pachai; J.-O. Fortrat; P. Gouny; Ali Badra; J. Berge; Y. Le Bras; J.-P. Cottier; J. Y. Gauvrit; P. Douek

doi:10.1016/j.neurad.2010.05.002

Journal articles

Overestimation of moderate carotid stenosis assessed by both Doppler US and contrast enhanced 3D-MR angiography in the CARMEDAS study.

Michel Nonent ^{1, 2} D. Ben Salem ^{2, *} J.-M. Serfaty ³ V. Buthion ⁴ A. Pasco-Papon ⁵ C. Rotaru ⁶ Luc Bressollette ^{1, 7} X. Papon ⁸ C. Pachai ⁹ J.-O. Fortrat ¹⁰ P. Gouny ¹¹ Ali Badra ¹¹ J. Berge ¹² Y. Le Bras ¹³ J.-P. Cottier ¹⁴ J. Y. Gauvrit ¹⁵ P. Douek ¹⁶

* Corresponding author

1 GETBO - Groupe d'Etude de la Thrombose de Bretagne Occidentale

2 DR - Brest - Département de radiologie [Brest]

3 DR- Bichat - Département de Radiologie [Bichat]

4 GATE - Health System Analysis Laboratory

5 DNR - Angers - Département de Neuro-Radiologie [Angers]

6 CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé

7 DMIP - Brest - Département de Médecine Interne et Pneumologie [Brest]

8 DCV - Angers - Département de Chirurgie Vasculaire [Angers]

9 B SAS - Bioclinica SAS

10 DA - Angers - Département d'Angiologie [Angers]

11 CCTV - Brest - Service de chirurgie thoracique et cardio vasculaire [Brest]

12 DNR - Bordeaux - Département de Neuro-Radiologie [Bordeaux]

13 DR - Niort - Département de Radiologie [Niort]

14 VisAGeS - Vision, Action et Gestion d'informations en Santé

INSERM - Institut National de la Santé et de la Recherche Médicale : U746, Inria Rennes – Bretagne Atlantique , IRISA-D5 - SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE

15 Service de radiologie et imagerie médicale [Rennes]

16 MOTIVATE - Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales

CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé : 139739

Abstract : PURPOSE: To evaluate the agreement and diagnostic accuracy of Contrast enhanced magnetic resonance angiography (CE-MRA), Doppler ultrasound (DUS) and Digital subtraction angiography (DSA) in the assessment of carotid stenosis. METHODS: DUS, CE-MRA and DSA were performed in 56 patients included in the Carotide-angiographie par résonance magnétique-échographie-doppler-angioscanner (CARMEDAS) multicenter study with a carotid stenosis ≥ 50%. Three readers evaluated stenoses on CE-MRA and DSA (NASCET criteria). Velocities criteria were used for stenosis estimation on DUS. RESULTS: CE-MRA had a sensitivity and specificity of 96-98% and 66-83% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 94% and 76-84% respectively for carotid stenoses ≥ 70%. The interobserver agreement of CE-MRA was excellent, except for moderate stenoses (50-69%). DUS had a sensitivity and specificity of 88 and 75% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 83 and 86% respectively for carotid stenoses ≥ 70%. Combined concordant CE-MRA and DUS had a sensitivity and specificity of 100 and 85-90% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 96-100% and 80-87% respectively for carotid stenoses ≥ 70%. The positive predictive value of the association CE-MRA and DUS for carotid stenoses ≥ 70% is calculated between 77 and 82% while the negative predictive value is calculated between 97 and 100%. CE-MRA and DUS have concordant findings in 63-72%, and the overestimations cases were recorded only for carotid stenosis ≤ 69%. CONCLUSION: Combined DUS-CE-MRA is excellent for evaluation of severe stenosis but remains debatable in moderate stenosis (50-69%) due to the risk of overestimations.

Document type :

Journal articles

Domain :

Life Sciences [q-bio] / Human health and pathology

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https://hal.univ-brest.fr/hal-00721482
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Submitted on : Friday, July 27, 2012 - 3:44:59 PM
Last modification on : Monday, October 11, 2021 - 2:23:07 PM

Overestimation of moderate carotid stenosis assessed by both Doppler US and contrast enhanced 3D-MR angiography in the CARMEDAS study.

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Overestimation of moderate carotid stenosis assessed by both Doppler US and contrast enhanced 3D-MR angiography in the CARMEDAS study.

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