DUPLEX SCANNING AND EFFECT OF MULTISEGMENTAL ARTERIAL-DISEASE ON ITS ACCURACY IN LOWER-LIMB ARTERIES

Aim: to assess the accuracy of duplex in assessment of peripheral arte rial disease and determine the effect of multisegmental disease on the accuracy duplex as opposed to single lesion. Patients and methods: on e hundred and seventy-seven lower limbs were examined in 90 patients w ho presented with lower limb arterial disease, (59 male, 31 female, me dian age 68 years - 81 with intermittent claudication, eight rest pain , one ulceration). Patients were examined with duplex US, and arteriog raphy (IA DSA). Two radiologists and two technologists were involved i n this double-blind study. Patients were classified into five groups; groups with single stenotic lesions, single occlusions, multiple steno tic lesions or occlusions, and multiple mixed disease. Duplex accuracy was determined in each group. Results: duplex was able to differentia te between normal and disease arterial segment with a sensitivity of 9 2%, specificity 99%, PPV 91%, and NPV 100% and Kappa 0.87. Sixty-six l imbs were found to have single lesions, and 68 multisegmental disease. Duplex showed accuracy with a sensitivity of 87%, and specificity of 99%, for single stenotic lesion and 95%, 96% respectively for multiseg mental. For single occlusions duplex accuracy showed sensitivity 92% a nd specificity 100%, and for multisegmental occlusions, sensitivity 97 %, and specificity 99%. For mixed multisegmental pathology (stenosis n ad occlusion), sensitivity 94% and specificity 97%. Conclusion: duplex is an accurate tool in diagnosis of lower limb arterial disease and m ultisegmental pathology does not adversely effect this accuracy.