Article Figures & Data
Tables
- Table 1:
Distribution of the clinical status (assessed by NIHSS on admission) of all patients enrolled and of the patients in different subgroups with pathologic finding
NIHSS on admission All Patients (n = 132) Pathologies on DSA No (n = 24) Extracranial (n = 72) Intracranial (n = 27) VA (n = 21) <4 79 16 43 15 11 4–7 40 6 21 8 9 8–11 8 1 7 1 0 ≥12 5 1 1 3 1 Note:—NIHSS indicates National Institutes of Health Stroke Scale score; DSA, digital subtraction angiography; VB, vertebrobasilar. Numbers of patients qualifying for the defined NIHSS ranges are shown.
n Embolic stroke 55 Transient ischemic attack 19 Low flow stroke 12 Asymptomatic ICA stenosis 8 Dissection 7 Intracerebral hemorrhage 7 Aneurysm 4 Vascular malformation 4 Stenosis/occlusion of basilar artery 4 Subarachnoid hemorrhage 3 Subclavian steal 3 Lacunar stroke 2 Other diagnoses 5 Note:—ICA indicates internal carotid artery.
- Table 3:
Diagnosis-based validation of all eTCCD-examinations (n = 164) in correlation to DSA
Reviewer 1 Reviewer 2 Consensus NE 4 (1–7) 4 (1–7) 4 (1–7) Sensitivity 82 (75–90) 80 (72–88) 82 (75–90) Specificity 96 (88–100) 98 (90–100) 98 (90–100) PPV 98 (92–100) 99 (93–100) 99 (94–100) NPV 75 (63–84) 73 (62–83) 75 (64–85) Note:—PPV indicates positive predictive value; NPV, negative predictive value; NE, not evaluable; eTCCD, echo-enhanced transcranial color-coded duplex sonography. All values are shown in percent. Numbers in parentheses represent 95% confidence intervals.
- Table 4:
Agreement between reviewers 1 and 2 for all eTCCD-examinations (n = 164) using κ-statistics
Reviewer 1 Reviewer 2 NE FN FP TN TP Total NE 6 0 1 0 0 7 FN 0 17 0 0 1 18 FP 0 0 0 2 0 2 TN 1 0 0 53 0 54 TP 0 3 0 0 80 83 Total 7 20 1 55 81 164 Note:—NE indicates not evaluable; FN, false negative; FP, false positive; TN, true negative; TP, true positive; eTCCD, echo-enhanced transcranial color-coded duplex sonography. The κ-value is 0.92 (95%-confidence interval: 0.87–0.97).
- Table 5:
Diagnosis-based validation of eTCCD subgroups in correlation to DSA after consensus review
Findings Abnormalities Normal (n = 24) Abnormal (n = 140) Extracranial (n = 98) Intracranial (n = 32) VB (n = 21) N.E. 4 (0–21) 4 (1–8) 6 (2–13) 0 (0–11) 0 (0–16) Sensitivity N/A 82 (74–89) 83 (71–92) 81 (64–93) 76 (53–92) Specificity 100 (85–100) 97 (84–100) 97 (84–100) N/A N/A PPV N/A 99 (94–100) 98 (89–100) 100 (87–100) 100 (79–100) NPV 100 (85–100) 64 (49–77) 76 (61–88) 0 (0–46) 0 (0–52) Note:—VB indicates vertebrobasilar; NE, not evaluable; PPV, positive predictive value; NPV, negative predictive value; N/A, not available; eTCCD, echo-enhanced transcranial color-coded duplex sonography; DSA, digital subtraction angiography. All values are shown in percent. Numbers in parentheses represent 95% confidence intervals.
- Table 6:
Visualization of the distinct arterial segments evaluable by eTCCD according to the separate assessment of the reviewers and after consensus review
Segment Reviewer 1 Reviewer 2 Consensus V4 99 99 99 M1 93 94 93 BA 94 88 91 P1 88 91 90 P2 87 91 89 C1 84 83 83 A1 84 81 82 M2 61 50 55 A2 48 42 45 AComA 27 24 26 PComA 23 25 24 Note:—V4 indicates V4-segment of the vertebral artery; M1/M2, M1-/M2-segment of the middle cerebral artery; BA, basilar artery; P1/P2, P1-/P2-segment of the posterior cerebral artery; C1–C1-segment of the internal carotid artery; A1/A2, A1-/A2-segment of the anterior cerebral arteries; AComA, anterior communicating artery; PComA, posterior communicating artery; eTCCD, echo-enhanced transcranial color-coded duplex sonography. All values are shown as percentages.
- Table 7:
Validation of eTCCD in comparison with DSA by analyzing the sensitivities, specificities, and positive and negative predictive values of the distinct arterial segments
Segment Sensitivity Specificity PPV NPV M1 87 (81–94) 98 (96–99) 92 (87–97) 96 (94–98) M2 76 (62–87) 100 (100–100) 100 (91–100) 95 (92–97) C1 84 (75–91) 99 (99–100) 97 (90–100) 96 (94–98) A1 77 (71–84) 97 (94–99) 94 (91–98) 85 (81–89) A2 70 (35–93) 100 (100–100) 100 (59–100) 99 (97–100) P1 74 (64–83) 99 (98–100) 96 (88–99) 92 (89–95) P2 77 (64–88) 99 (98–100) 93 (81–99) 96 (94–98) PComA 91 (81–97) 79 (68–88) 78 (66–87) 92 (82–97) AComA 94 (86–98) 86 (42–100) 98 (92–100) 60 (26–88) V4 78 (64–89) 99 (97–100) 92 (79–98) 96 (93–98) BA 76 (50–93) 99 (97–100) 87 (60–98) 97 (94–100) Note:—PPV indicates positive predictive value; NPV, negative predictive value; PComA, posterior communicating artery; AComA, anterior communicating artery; M1/M2, M1-/M2-segment of the middle cerebral artery; C1, C1-segment of the internal carotid artery; A1/A2, A1-/A2-segment of the anterior cerebral arteries; P1/P2, P1-/P2-segment of the posterior cerebral artery; V4, V4-segment of the vertebral artery; BA, basilar artery; eTCCD, echo-enhanced transcranial color-coded duplex sonography; DSA, digital subtraction angiography. The displayed values refer to the datasets obtained by both reviewers. All values are shown as percentages. Numbers in parentheses represent 95% confidence intervals.
