Diagnosis of arterial occlusive disease of the upper extremities:: Comparison of color duplex sonography and angiography

Purpose. The aim of this study was to assess the abilities of color duplex sonography (CDUS) to detect and characterize arterial occlusive disease of the upper extremities. Methods. We prospectively compared the results of CDUS with those of intra-arterial digital subtraction angiography, which were considered definitive, in patients with symptomatic arterial occlusive disease of the upper extremities. In each extremity, we visualized 9 arterial segments, which were each evaluated for stenoses and occlusions. Each segment was categorized on each imaging modality as not significantly narrowed (narrowed by <50%), significantly narrowed (narrowed by greater than or equal to50% but <100%), or occluded (100%). Results. We examined a total of 578 segments in 57 patients (34 men and 23 women) with a mean age of 50 years (range, 20-74 years). CDUS had a sensitivity, a specificity, a positive predictive value, a negative predictive value, and an accuracy of 98%, 99%, 97%, 99.5%, and 99%, respectively, for detecting occluded lesions and 79%, 100%, 100%, 99%, and 99%, respectively, for detecting hemodynamically significantly stenotic lesions. Notably, the sensitivity of CDUS for diagnosing significantly stenotic lesions (79%) was lower than that for diagnosing occlusive disease (98%). Conclusions. With high sensitivity and accuracy rates, CDUS is a reliable screening method for detecting arterial occlusive disease of the upper extremities. This modality efficiently provides anatomic and hemodynamic data that are useful in cases of such disease. (C) 2003 Wiley Periodicals, Inc.