Evaluation of Color Coded Ultrasound (CCU) for Quantitative Morphometry of Peripheral Arteries as Compared to Angiography: Results of the PeriQuant Registry Study

Problemstellung:

Aims: Detection of restenosis by morphologic differentiation of lumen from plaque is an important issue for ultrasonography (US). For evaluation of target lumen reduction (TLR) mostly indirect US-parameters like peak velocity ratios are used.

Purpose: To quantitatively assess TLR as a marker of morphometry by intensity-coded power doppler (ICPD) as compared to Color-Doppler (CD), hemodynamic changes in flow velocity and angiography.

Patienten und Methode:

Patients and Methods: US was performed with a IU 22 (Philips, Germany) using a linear 4–8 Mhz probe. For B-mode imaging XRES and SonoCT was employed. For CD and ICPD dynamic range, persistence, line density and priority were adjusted to maximum sensitivity. Prospective evaluation was off-line by two blinded readers using QLab software (Philips Deutschland, Hamburg). Catheter angiography (Angio) was performed by planes corresponding to longitudinal US-sections (LUSS) with a Siemens HICOR (Siemens, Germany) and evaluated by standard QCA software (Medis, Netherlands). Postinterventional LUSS, cross US-sections (CUSS) and angio were performed in 50 patients with recent stenting of superficial femoral artery (SFA).

Ergebnisse:

Results: When using ICPD, LUSS and CUSS, axial resolution correlated better with angio than with CD-US. Pearsons Correlations of angiographic diameters with ICPD cross-section views were in stent 0,51 and proximal to stents 0,76 as with longitudinal sections in stent 0,69 and proximal to stents 0,89. ICPD and CD-US underestimated angiographic values predominantly in stent (Bland Altmann, p<0,05).

Schlussfolgerungen:

Conclusion: ICPD is suggested to be suitable for analysis of stenosis proximal to stents and morphologic assessment in stent at least in a combined approach with flow measurements.