Background
Peak systolic velocity (PSV) is measured with pulse-wave (PW) Doppler with angle correction
in patients with internal carotid artery stenosis (ICAS). However, the correlation
between conventional angiography and PSV shows considerable scattering. We hypothesized
that measuring PSV without angle correction would lead to better inter-rater reliability.
This hypothesis was tested using a sector probe and continuous-wave (CW) Doppler without
angle correction.
Methods
Consecutive patients with more than 50% ICAS were enrolled from a prospective database.
PSV was measured with PW Doppler with angle correction (PW PSV) and CW Doppler without
angle correction (CW PSV) by 2 examiners. The inter-rater reliabilities of PW PSV
and CW PSV were analyzed by Spearman's rank correlation test.
Results
A total of 37 ICAS sites (median 67 [interquartile range 57-78] % stenosis) were enrolled.
Measuring PSV using a sector probe insonating nearly parallel to the flow was feasible
in all cases. Inter-rater reproducibility of CW PSV (Spearman's ρ = .810) was similar
to that of PW PSV (Spearman's ρ = .796). When limited to patients with a PSV greater
than 200 cm/s with both PW Doppler examinations (25 ICAS sites), inter-rater reliability
was relatively higher for CW PSV (Spearman's ρ = .674) than for PW PSV (Spearman's
ρ = .423).
Conclusions
Measuring PSV with CW Doppler using a sector probe was feasible. Inter-rater reliability
was similar between PW Doppler with angle correction and CW Doppler without angle
correction in evaluating PSV in patients with ICAS. CW Doppler appears to have better
inter-rater reproducibility than PW Doppler in assessing high PSV.
Key Words
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Article info
Publication history
Published online: March 14, 2016
Accepted:
December 10,
2015
Received in revised form:
November 14,
2015
Received:
September 19,
2015
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.12.009
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
