Variable
Mean
Median
SD
Min.
Max.
P value
Celiac PSV
≥50 native stenosis
≥50 stenting stenosis
379
447
335
428
149.7
158.4
52
205
880
903
0.0670
Celiac EDV
≥50 native stenosis
≥50 stenting stenosis
104
136
77
105
77.7
99.2
18
25
463
438
0.1058
Celiac/aortic PSV ratio
≥50 native stenosis
≥50 stenting stenosis
5.2
7.1
4.8
6.4
2.7
3.6
0.4
1.7
14.5
14.5
<0.001
SMA PSV
≥50 native stenosis
≥50 stenting stenosis
405
410
401
377
124.9
177.4
150
119
783
975
0.885
SMA EDV
≥50 native stenosis
≥50 stenting stenosis
76
114
60
78
54.9
112.8
18
20
375
423
0.0366
SMA/aortic PSV ratio
≥50 native stenosis
≥50 stenting stenosis
1.9
6.2
2.0
5.4
1.6
3.4
0.2
0.8
7.4
13.9
<0.0001
The mean and median velocities for ≥50% versus <50% stenosis of the stented CAs and SMAs are summarized and compared in Table 52.2.
Table 52.2
Mean velocities for ≥50% versus <50% stenosis of stented CA and SMA
Variable | Mean | Median | SD | Min. | Max. | P value |
|---|---|---|---|---|---|---|
Celiac PSV | ||||||
<50 ≥50 | 173 447 | 167 428 | 62.12 158.41 | 96 205 | 283 903 | 0.0001 |
Celiac EDV | ||||||
<50 ≥50 | 36 136 | 38 105 | 13.53 99.16 | 13 25 | 51 438 | 0.003 |
Celiac/aortic PSV | ||||||
<50 ≥50 | 2.3 7.1 | 2.2 6.4 | 0.72 3.61 | 1.17 1.69 | 3.4 14.5 | 0.0007 |
SMA PSV | ||||||
<50 ≥50 | 220 410 | 214 377 | 70.85 177.42 | 139 119 | 295 975 | 0.0025 |
SMA EDV | ||||||
<50 ≥50 | 34 114 | 27 78 | 15.33 112.81 | 22 20 | 60 423 | 0.0211 |
SMA/aortic PSV | ||||||
<50 ≥50 | 3.1 6.2 | 2.6 5.4 | 2.13 3.42 | 0.79 0.76 | 6.8 13.9 | 0.0412 |
The sensitivity, specificity, PPV, NPV, and OA for various velocity thresholds for detecting SMA and CA ≥50% in-stent stenosis are summarized in Tables 52.3 and 52.4. The PSV cut point with the best OA for detecting ≥50% SMA in-stent stenosis was 325 cm/s (sensitivity of 89%, specificity of 100%, and OA of 91%). In contrast, the cut point with the best OA for detecting ≥50% native SMA stenosis was 295 cm/s (sensitivity 87%, specificity 89%, and OA 88%, Table 52.3). The PSV velocity cut point with the best OA for ≥50% CA in-stent stenosis was 274 cm/s (sensitivity 96%, specificity 86%, and OA 93%), in contrast to 240 cm/s for ≥50% native stenosis (sensitivity 88%, specificity 83%, OA 87%) [14].
Table 52.3
Sensitivity , specificity, positive predictive value, negative predictive value, and overall accuracy for various velocity thresholds for detecting ≥50% SMA in-stent stenosis
Group (≥) | Sensitivity | 95% CI | Specificity | 95% CI | PPV | NPV | Accuracy |
|---|---|---|---|---|---|---|---|
SMA PSV 164 | 96 | (88.8, 103.6) | 17 | (−13.2, 46.5) | 83 | 50 | 81 |
SMA PSV 168 | 96 | (88.8, 103.6) | 33 | (−4.4, 71.1) | 86 | 67 | 84 |
SMA PSV 177 | 96 | (88.8, 103.6) | 50 | (10, 90.0) | 89 | 75 | 88 |
SMA PSV 208 | 92 | (82.1, 102.6) | 50 | (10, 90.0) | 89 | 60 | 84 |
SMA PSV 260 | 89 | (76.2, 100.7) | 50 | (10, 90.0) | 89 | 50 | 81 |
SMA PSV 294 | 89 | (76.2, 100.7) | 67 | (29, 104.4) | 92 | 57 | 84 |
SMA PSV 295 | 89 | (76.2, 100.7) | 83 | (53.5, 113.2) | 96 | 63 | 88 |
SMA PSV * 325 | 89 | (76.2, 100.7) | 100 | (100, 100) | 100 | 67 | 91 |
SMA PSV 328 | 85 | (70.8, 98.5) | 100 | (100, 100) | 100 | 60 | 88 |
SMA PSV 331 | 81 | (65.6, 95.9) | 100 | (100, 100) | 100 | 55 | 84 |
SMA PSV 336 | 77 | (60.7, 93.1) | 100 | (100, 100) | 100 | 50 | 81 |
SMA PSV 337 | 73 | (56.0, 90.1) | 100 | (100, 100) | 100 | 46 | 78 |
SMA EDV 23 | 92 | (81.4, 102.6) | 17 | (−13.2, 46.5) | 82 | 33 | 77 |
SMA EDV 26 | 92 | (81.4, 102.6) | 33 | (−4.4, 71.1) | 85 | 50 | 81 |
SMA EDV 27 * | 92 | (81.4, 102.6) | 50 | (10, 90.0) | 89 | 60 | 84 |
SMA EDV 30 * | 88 | (75.3, 100.7) | 67 | (29, 104.4) | 92 | 57 | 84 |
SMA EDV 32 | 84 | (69.6, 98.4) | 67 | (29, 104.4) | 91 | 50 | 81 |
SMA EDV 44 | 80 | (64.3, 95.7) | 67 | (29, 104.4) | 91 | 44 | 77 |
SMA EDV 45 | 76 | (59.3, 92.7) | 67 | (29, 104.4) | 91 | 40 | 74 |
SMA EDV 48 | 76 | (59.3, 92.7) | 83 | (53.5, 113.2) | 95 | 46 | 77 |
SMA EDV 50 | 72 | (54.4, 89.6) | 83 | (53.5, 113.2) | 95 | 42 | 74 |
S/A PSV ratio 0.79 | 96 | (88.3, 103.7) | 0 | (0, 0) | 80 | 0 | 77 |
S/A PSV ratio 1.87 | 96 | (88.3, 103.7) | 17 | (−13.2, 46.5) | 83 | 50 | 81 |
S/A PSV ratio 2.11 | 92 | (81.4, 102.6) | 33 | (−4.4, 71.1) | 85 | 50 | 81 |
S/A PSV ratio 2.78 | 88 | (75.3, 100.7) | 50 | (10, 90.0) | 88 | 50 | 81 |
S/A PSV ratio 3.46 * | 88 | (75.3, 100.7) | 67 | (29, 104.4) | 92 | 57 | 84 |
S/A PSV ratio 3.47 | 84 | (69.6, 98.4) | 67 | (29, 104) | 91 | 50 | 81 |
S/A PSV ratio 4.14 | 80 | (64.3, 95.7) | 67 | (29, 104.4) | 91 | 44 | 77 |
S/A PSV ratio 4.22 | 76 | (59.3, 92.7) | 83 | (53.5, 113.2) | 95 | 46 | 77 |
Table 52.4
Sensitivity , specificity, positive predictive value, negative predictive value, and overall accuracy for various velocity thresholds for detecting ≥50% CA in-stent stenosis
≥50% Restenosis | |||||||
|---|---|---|---|---|---|---|---|
Group (≥) | Sensitivity | 95% CI | Specificity | 95% CI | PPV | NPV | Accuracy |
Celiac PSV 136 | 100 | (100, 100) | 29 | (−4.9, 62.0) | 82 | 100 | 83 |
Celiac PSV 167 | 100 | (100, 100) | 43 | (6.2, 79.5) | 85 | 100 | 87 |
Celiac PSV 200 | 100 | (100, 100) | 57 | (20.5, 93.8) | 89 | 100 | 90 |
Celiac PSV 274 * | 96 | (87.3, 104) | 86 | (59.8, 111.6) | 96 | 86 | 93 |
Celiac PSV 283 | 91 | (79.8, 102.8) | 86 | (59.8, 111.6) | 96 | 75 | 90 |
Celiac PSV 301 | 91 | (79.8, 102.8) | 100 | (100, 100) | 100 | 78 | 93 |
Celiac PSV 308 | 87 | (73.2, 100.7) | 100 | (100, 100) | 100 | 70 | 90 |
Celiac PSV 312 | 83 | (67.1, 98.1) | 100 | (100, 100) | 100 | 64 | 87 |
Celiac PSV 322 | 78 | (61.4, 95.1) | 100 | (100, 100) | 100 | 58 | 83 |
Celiac EDV 38 | 87 | (73.2, 100.7) | 43 | (6.2, 79.5) | 83 | 50 | 77 |
Celiac EDV 40 | 87 | (73.2, 100.7) | 57 | (20.5, 93.8) | 87 | 57 | 80 |
Celiac EDV 42 | 83 | (67.1, 98.1) | 57 | (20.5, 93.8) | 86 | 50 | 77 |
Celiac EDV 50 | 83 | (67.1, 98.1) | 71 | (38, 104.9) | 91 | 56
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