Sensitivity, specificity and predictive value of clinical findings, m-mode echocardiography and continuous-wave Doppler sonography in the diagnosis of symptomatic patent ductus arteriosus in preterm infants.
By means of probability analysis we have compared the diagnostic value of clinical symptoms, m-mode echocardiographic measurements and peripheral arterial flow, assessed by continuous-wave Doppler, in preterm infants with symptomatic patent ductus arteriosus (PDA). Data were obtained in 29 infants with PDA and in 29 controls. The most sensitive clinical finding was a hyperactive precordium. Bounding pulses and a heart murmur were absent in 15% and 20%, respectively of the patients with PDA. M-mode echocardiographic measurements were rather specific for the detection of a PDA but less sensitive. Diastolic backflow in the brachial and femoral arteries was present in the majority of patients with PDA and absent in about 67% of the controls. The values in probability analysis, however, were too low to base a therapy on these findings. The highest sensitivity and specificity (100% each) was found for a disturbed cerebral blood flow with absent or retrograde diastolic perfusion estimated by Doppler sonography.
Kupferschmid
C
C
Universitätskinderklinik, Ulm, Federal Republic of Germany.
Lang
D
D
Pohlandt
F
F
D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D006321:Heart / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D014463:Ultrasonography