Comparison of Noninvasive Imaging Modalities for Stenosis Grading in Mesenteric Arteries
Open accessAbstract
OBJECTIVE: To prospectively analyze duplex sonography, CTA, and MRA with respect to stenosis grading of the celiac trunk (TC) and the superior mesenteric artery (SMA), with DSA as the reference. MATERIALS AND METHODS: 52 subjects were enrolled (mean age: 71). The image quality was graded: 1-insufficient, 2-bad, 3-moderate, 4-good or 5-excellent. Stenosis was graded: 1 (< 25 %), 2 (25 - < 50 %), 3 (50 - 75 %) or 4 (75 %). Two-sided chi-square tests were used to check for correlation of stenosis grading between modalities. The weighted Cohen's kappa was calculated to assess the strength of correlation. With a threshold of 50 % for non-relevant stenosis vs. relevant stenosis, the sensitivity, specificity, PPV, NPV, and accuracy were calculated. RESULTS: The mean image quality was 3.8 ± 0.7, 3.1 ± 1.0, 4.4 ± 0.7, and 3.8 ± 0.9 for DSA, duplex sonography, CTA, and MRA, respectively. For both TC and SMA, stenosis grading reached a significant level of correlation between each noninvasive modality with DSA (p < 0.001, each). The weighted Cohen's kappa for duplex sonography/CTA/MRA was 0.94/0.93/0.74, respectively, for the TC and 0.64/0.91/0.56, respectively, for the SMA. Highest sensitivity/specificity/NPV/PPV/accuracy were found for CTA with 100 %/95 %/85 %/100 %/96 % for the TC and with na/98 %/na/100 %/98 %, respectively, for the SMA. CONCLUSION: CTA provided the best image quality, reached the highest level of agreement and significance in correlation in stenosis grading, and offered the best diagnostic accuracy.
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In a study of 52 patients, CTA had the highest accuracy to detect significant CA stenosis or SMA stenosis compared with DUS and MRA.
“In a study of 52 patients, CTA had the highest accuracy to detect significant CA stenosis ( n ¼ 12) or SMA stenosis ( n ¼ 2) compared with DUS and MRA, although patients had DSA during endovascular abdominal aortic aneurysm repair, and not for CMI. 34”
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- Authors
- Schaefer, P., Pfarr, J., Trentmann, J., Wulff, A., Langer, C., Siggelkow, M., Groß, J., Knabe, H., & Schaefer, F.
- Affiliations
- University Hospital Schleswig-Holstein (DE)
- Venue
- RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren
- Publisher
- Georg Thieme Verlag KG
- Published
- 2013-06-05
- Volume
- 185
- Issue
- 07
- Pages
- 628-634
- ISSN
- 1438-9010 (ISSN-L)
- 1438-9029
- OpenAlex
- W2067066221
- Cited by
- 52
- References
- 5
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 3 · 2020: 10 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 3.92
- Type
- journal article
- Language
- de
- Open access
- bronze
- doi.org
- Locations
- RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Keywords
- mesenteric artery stenosis, celiac artery, superior mesenteric artery, stenosis grading, duplex ultrasound, CT angiography, magnetic resonance angiography, digital subtraction angiography, diagnostic accuracy, image quality, intermodality agreement
- MeSH terms
- Adult, Aged, Aged, 80 and over, Constriction, Pathologic, Female, Humans, Ischemia, Male, Middle Aged, Sensitivity and Specificity, Tomography, X-Ray Computed, Vascular Diseases, Reproducibility of Results, Ultrasonography, Doppler, Duplex, Magnetic Resonance Angiography, Mesenteric Ischemia
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