[Interobserver variation in ultrasonographic scanning of carotid stenosis].
BACKGROUND
Ultrasonic carotid interna scanning is today the gold standard for diagnosing carotid stenosis in patients with stroke or transient ischemic attack. The procedure of ultrasonic carotid interna scanning is not a well-defined procedure. Knowledge of the reproducibility of the method used in own department is important in order to evaluate its usefulness.


METHODS
Interobserver variability of ultrasonic, duplex carotid artery scanning was examined in 68 carotid arteries in 35 patients by two experienced technologists. The two observers were compared using the kappa (kappa) statistics to analyse the agreement beyond chance.


RESULTS
kappa was 0.70 (CI: 0.56-0.83) when the stenoses were categorised in the intervals 0-14%, 15-49%, 50-69%, 70-79%, 80-99% and occlusion. Categorising the stenosis in the clinically relevant intervals 0-69%, 70-79% and occlusion which are used to determine if the patient is a candidate or not to carotid endarterectomy yielded a kappa = 0.92 (CI: 0.81-1.00).


CONCLUSIONS
Low level stenosis accounted for most variability. If state-of-the-art ultrasonic equipment and experienced technologists are used a high level of reproducibility can be achieved.
Kofoed
Peter Kristian
PK
Karkirurgisk Afdeling B, Amtssygehuset i Gentofte. peter_kofoed@hotmail.com
Kofoed
Steen Christian
SC
Grønholdt
Marie-Louise Moes
ML
Sillesen
Henrik H
HH
D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery; D002983:Clinical Competence; D004691:Endarterectomy; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D014463:Ultrasonography