Concordance rate differences of 3 noninvasive imaging techniques to measure carotid stenosis in clinical routine practice: results of the CARMEDAS multicenter study.

Michel Nonent; Jean-Michel Serfaty; Norbert Nighoghossian; François Rouhart; Laurent Derex; Carmen Rotaru; Pierre Chirossel; Bruno Guias; Jean-François Heautot; Pierre Gouny; Bernard Langella; Valérie Buthion; Isabelle Jars; Chahin Pachai; Charles Veyret; Jean-Yves Gauvrit; Michel Lamure; Philippe C Douek

doi:10.1161/01.STR.0000117251.65222.DA

Journal articles

Concordance rate differences of 3 noninvasive imaging techniques to measure carotid stenosis in clinical routine practice: results of the CARMEDAS multicenter study.

Michel Nonent ^{1, 2, *} Jean-Michel Serfaty ³ Norbert Nighoghossian ⁴ François Rouhart ⁵ Laurent Derex ⁶ Carmen Rotaru ⁷ Pierre Chirossel ⁷ Bruno Guias ⁸ Jean-François Heautot ⁹ Pierre Gouny ¹⁰ Bernard Langella ⁹ Valérie Buthion ¹¹ Isabelle Jars ¹² Chahin Pachai ¹³ Charles Veyret ¹⁴ Jean-Yves Gauvrit ^{9, 15, 16} Michel Lamure ¹² Philippe C Douek ¹⁷

* Corresponding author

1 DR - Brest - Département de radiologie [Brest]

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

3 LBPC - Hémostase, bio-ingénierie et remodelage cardiovasculaires

4 Cerebrovascular Unit [Lyon]

5 Service de Neurologie [Brest]

6 Service de Neurologie [Lyon]

7 Service de Radiologie [Hôpital de la Croix-Rousse - HCL]

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

9 Service de radiologie et imagerie médicale [Rennes]

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

11 COACTIS - COACTIS

12 LASS - Laboratoire d'analyse des systèmes de santé

13 Theralys [Lyon]

14 Service de radiologie [Saint-Etienne]

15 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

16 Plateforme neurinfo [Rennes]

17 CREATIS - Centre de Recherche et d'Application en Traitement de l'Image et du Signal

Abstract : BACKGROUND AND PURPOSE: To replace digital subtraction angiography (DSA) in carotid stenosis evaluation, noninvasive imaging techniques have to reach a high concordance rate. Our purpose is to compare the concordance rates of contrast-enhanced MR angiography (CEMRA) and CT angiography (CTA) with Doppler ultrasound (DUS) in clinical routine practice. METHODS: We evaluated prospectively with DUS, CEMRA, and CTA 150 patients suspected of carotid stenosis. The overall concordance rates of the 3 techniques were calculated for symptomatic stenosis > or =50% and > or =70%, for asymptomatic stenosis > or =60%, and for occlusion. For the carotid arteries treated by surgery (n=97), the results of each method and combined techniques were recorded, and misclassification rates were evaluated from surgical reports. RESULTS: The overall concordance rates of DUS-CEMRA, DUS-CTA, and CEMRA-CTA were not statistically different. However, the concordance rate of DUS-CEMRA (92.53%) was significantly higher than that for DUS-CTA (79.10%) in the surgical asymptomatic stenosis group (P=0.0258). CTA considered alone would misclassify the stenosis in a significant number of cases (11 of 64) in the surgical asymptomatic group compared with CEMRA (3 of 67) and DUS (1 of 66) (P=0.0186 versus MRA, P=0.0020 versus DUS). CONCLUSIONS: With the techniques as utilized in our study, the overall concordance rates of combined noninvasive methods are similar for measuring carotid stenosis in clinical routine practice, but in asymptomatic carotid stenosis, the decision making for surgery is significantly altered if DUS and CTA are considered in place of DUS and CEMRA.

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Journal articles

Domain :

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

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https://hal.univ-brest.fr/hal-00722109
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Submitted on : Tuesday, July 31, 2012 - 4:51:21 PM
Last modification on : Tuesday, October 19, 2021 - 11:58:48 PM

Concordance rate differences of 3 noninvasive imaging techniques to measure carotid stenosis in clinical routine practice: results of the CARMEDAS multicenter study.

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Concordance rate differences of 3 noninvasive imaging techniques to measure carotid stenosis in clinical routine practice: results of the CARMEDAS multicenter study.

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