Usefulness of “AcT ratio” in diagnosis of internal carotid artery stenosis: a multicenter, retrospective, observational study

IF 1.9 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Ultrasonics Pub Date : 2024-04-06 DOI:10.1007/s10396-024-01409-z

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引用次数: 0

Abstract

Purpose

The ratio of the internal carotid artery (ICA) to the common carotid artery (CCA), especially the “AcT ratio,” which is a modified measurement method of acceleration time, is useful for diagnosing ICA-origin stenosis. However, previous studies were single-center studies. Therefore, this multicenter, retrospective, cross-sectional study aimed to determine whether a method using the AcT ratio is useful for estimating stenosis rates.

Methods

This study included 461 vessels subjected to carotid artery ultrasonography and evaluation for ICA-origin stenosis via NASCET at four hospitals. The duration from the steep rise point to the inflection point or the first peak was defined as AcT on pulsed wave Doppler. The AcT ratio was calculated as AcT of ICA/AcT of ipsilateral CCA. The AcT ratio and rate of ICA-origin stenosis were analyzed using Pearson's correlation coefficient, simple regression analysis, and ROC curve.

Results

A significant positive correlation was observed between the AcT ratio and NASCET stenosis. NASCET stenosis of ≥ 50% had a sensitivity, specificity, and negative predictive value (NPV) of 70.2%, 71.6%, and 91.5%, respectively, when the cut-off value of the AcT ratio was 1.17. NASCET stenosis of ≥ 70% had a sensitivity, specificity, and NPV of 70.5%, 72.1%, and 95.9%, respectively, when the cut-off value of the AcT ratio was 1.22.

Conclusions

The findings of this multicenter, retrospective, cross-sectional study suggest that the AcT ratio is useful for diagnosing ICA-origin stenosis, especially for diagnosis by exclusion. NASCET stenosis of ≥ 50% was considered unlikely if the Act ratio was ≤ 1.17, whereas NASCET stenosis of ≥ 70% was considered unlikely if it was ≤ 1.22.

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AcT比值 "在颈内动脉狭窄诊断中的实用性：一项多中心、回顾性、观察性研究

摘要目的颈内动脉（ICA）与颈总动脉（CCA）的比值，尤其是 "AcT 比值"（一种改良的加速时间测量方法），有助于诊断颈内动脉源性狭窄。然而，以前的研究都是单中心研究。因此，这项多中心、回顾性、横断面研究旨在确定使用 AcT 比值的方法是否有助于估计狭窄率。方法这项研究包括在四家医院接受颈动脉超声检查和通过 NASCET 评估 ICA 起源狭窄的 461 条血管。从陡峭上升点到拐点或第一个峰值的持续时间被定义为脉冲波多普勒的 AcT。AcT比率按ICA的AcT/同侧CCA的AcT计算。采用皮尔逊相关系数、简单回归分析和 ROC 曲线对 AcT 比值和 ICA 起源狭窄率进行分析。结果 AcT 比值与 NASCET 狭窄程度呈明显正相关。当 AcT 比值的临界值为 1.17 时，NASCET 狭窄程度≥ 50%的敏感性、特异性和阴性预测值（NPV）分别为 70.2%、71.6% 和 91.5%。当 AcT 比值的临界值为 1.22 时，NASCET 狭窄度≥ 70% 的敏感性、特异性和 NPV 分别为 70.5%、72.1% 和 95.9%。结论这项多中心、回顾性、横断面研究的结果表明，AcT 比值有助于诊断 ICA 起源狭窄，尤其是在排除性诊断中。如果Act比值≤1.17，则认为NASCET狭窄≥50%的可能性不大，而如果Act比值≤1.22，则认为NASCET狭窄≥70%的可能性不大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Ultrasonics 医学-核医学

CiteScore

3.30

自引率

11.10%

发文量

102

审稿时长

>12 weeks

期刊介绍： The Journal of Medical Ultrasonics is the official journal of the Japan Society of Ultrasonics in Medicine. The main purpose of the journal is to provide forum for the publication of papers documenting recent advances and new developments in the entire field of ultrasound in medicine and biology, encompassing both the medical and the engineering aspects of the science.The journal welcomes original articles, review articles, images, and letters to the editor.The journal also provides state-of-the-art information such as announcements from the boards and the committees of the society.