Table 2.
Sensitivity and specificity comparison between duplex ultrasound, CTA and MRA
| Studies | Number of subjects (N) | Age group (years) | Severity (S) | Sensitivity (%) | Specificity (%) | Remarks |
|---|---|---|---|---|---|---|
| Computed tomography angiography (CTA) | ||||||
| Marks et al. [76] | 14 | 49–84 | 0% ≤ S ≤ 30% | 86 | – | CTA results were 89% accurate compared to conventional angiography |
| 30% ≤ S ≤ 69% | 86 | |||||
| 70% ≤ S ≤ 99% | 100 | |||||
| Farres et al. [77] | 24 | 48–88 | 50% ≤ S ≤ 99% | 100 | 95.2 |
Sensitivity—95% CI, 15.8% to 100% Specificity—95% CI, 83.8% to 99.4% |
| Anderson et al. [78] | 40 | 44–83 | 50% ≤ S ≤ 99% | 89 | 91 | For mild stenosis (0–29%) and occlusion, CTA was found to be almost 100% accurate |
| Koelemay et al. [79] |
864 (meta-analysis) |
55–73 | 70% ≤ S ≤ 99% | 85 | 93 |
Sensitivity—95% CI, 95% CI, 79% to 89% Specificity—95% CI, 89% to 96% |
| Wardlaw et al. [74] |
372 (meta-analysis) |
– | 70% ≤ S ≤ 99% | 77 | 95 |
Sensitivity—95% CI, 68% to 84% Specificity—95% CI, 91% to 97% |
| Magnetic resonance angiography (MRA) | ||||||
| Cosottini et al. [80] | 92 | 45–82 | 0% ≤ S ≤ 99% | 97 | 82 | The patients were clinically and ultrasonically tested for stenosis sign earlier |
| Nederkoorn et al. [67] | 350 | 39–88 | 70% ≤ S ≤ 99% | 92.2 | 75.7 |
Sensitivity—95% CI, 86.2% to 96.2% Specificity—95% CI, 68.6% to 82.5% |
| Nederkoorn et al. [73] | Meta-analysis | – |
S < 70% versus 70% ≤ S ≤ 99% |
95 | 90 |
Pooled weighted analysis Sensitivity—95% CI, 92% to 97% Specificity—95% CI, 86% to 93% |
| Wardlaw et al. [74] |
380 (contrast enhanced MRA) |
Meta-analysis | 70% ≤ S ≤ 99% | 94 | 93 |
Sensitivity—95% CI, 88% to 97% Specificity—95% CI, 89% to 96% |
|
774 (MRA) |
88 | 84 |
Sensitivity—95% CI, 82% to 92% Specificity—95% CI, 76% to 97% |
|||
| Duplex ultrasound (DUS) | ||||||
| Huston et al. [66] | 621 | 14–88 | 50% ≤ S ≤ 70% | 86.4 | 90.1 | Peak systolic and end diastolic velocity of 230 cm/s and 70 cm/s, respectively, were evaluated for stenosis ≥ 70% |
| 70% ≤ S ≤ 99% | 92.1 | 89.5 | ||||
| Nederkoorn et al. [67] | 350 | 39–88 | 70% ≤ S ≤ 99% | 87.5 | 75.7 |
Sensitivity—95% CI, 82.1% to 92.9% Specificity—95% CI, 69.3% to 82.2% |
| Nederkoorn et al. [73] | Meta-analysis | – |
S < 70% versus 70% ≤ S ≤ 99% |
86 | 87 |
Pooled weighted analysis Sensitivity—95% CI, 84% to 89% Specificity—95% CI, 84% to 90% |
| Jahromi et al. [81] | Meta-analysis | – | 50% ≤ S < 70% | 98 | 88 | Standards for Reporting of Diagnostic Accuracy (STARD) criteria was used for the study |
| S ≥ 70% | 90 | 94 | ||||
| Wardlaw et al. [74] |
916 (meta-analysis) |
– | 70% ≤ S ≤ 99% | 89 | 84 |
Sensitivity—95% CI, 85% to 92% Specificity—95% CI, 77% to 89% |