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Table 2 Sensitivity and specificity comparison between duplex ultrasound, CTA and MRA

From: Imaging modalities to diagnose carotid artery stenosis: progress and prospect

Studies Number of subjects (N) Age group (years) Severity (S) Sensitivity (%) Specificity (%) Remarks
Computed tomography angiography (CTA)
 Marks et al. [76] 14 49–84 0% ≤ S ≤ 30% 86 CTA results were 89% accurate compared to conventional angiography
30% ≤ S ≤ 69% 86
70% ≤ S ≤ 99% 100
 Farres et al. [77] 24 48–88 50% ≤ S ≤ 99% 100 95.2 Sensitivity—95% CI, 15.8% to 100% Specificity—95% CI, 83.8% to 99.4%
 Anderson et al. [78] 40 44–83 50% ≤ S ≤ 99% 89 91 For mild stenosis (0–29%) and occlusion, CTA was found to be almost 100% accurate
 Koelemay et al. [79] 864 (meta-analysis) 55–73 70% ≤ S ≤ 99% 85 93 Sensitivity—95% CI, 95% CI, 79% to 89% Specificity—95% CI, 89% to 96%
 Wardlaw et al. [74] 372 (meta-analysis) 70% ≤ S ≤ 99% 77 95 Sensitivity—95% CI, 68% to 84% Specificity—95% CI, 91% to 97%
Magnetic resonance angiography (MRA)
 Cosottini et al. [80] 92 45–82 0% ≤ S ≤ 99% 97 82 The patients were clinically and ultrasonically tested for stenosis sign earlier
 Nederkoorn et al. [67] 350 39–88 70% ≤ S ≤ 99% 92.2 75.7 Sensitivity—95% CI, 86.2% to 96.2% Specificity—95% CI, 68.6% to 82.5%
 Nederkoorn et al. [73] Meta-analysis S < 70% versus 70% ≤ S ≤ 99% 95 90 Pooled weighted analysis Sensitivity—95% CI, 92% to 97% Specificity—95% CI, 86% to 93%
 Wardlaw et al. [74] 380 (contrast enhanced MRA) Meta-analysis 70% ≤ S ≤ 99% 94 93 Sensitivity—95% CI, 88% to 97% Specificity—95% CI, 89% to 96%
774 (MRA) 88 84 Sensitivity—95% CI, 82% to 92% Specificity—95% CI, 76% to 97%
Duplex ultrasound (DUS)
 Huston et al. [66] 621 14–88 50% ≤ S ≤ 70% 86.4 90.1 Peak systolic and end diastolic velocity of 230 cm/s and 70 cm/s, respectively, were evaluated for stenosis ≥ 70%
70% ≤ S ≤ 99% 92.1 89.5
 Nederkoorn et al. [67] 350 39–88 70% ≤ S ≤ 99% 87.5 75.7 Sensitivity—95% CI, 82.1% to 92.9% Specificity—95% CI, 69.3% to 82.2%
 Nederkoorn et al. [73] Meta-analysis S < 70% versus 70% ≤ S ≤ 99% 86 87 Pooled weighted analysis Sensitivity—95% CI, 84% to 89% Specificity—95% CI, 84% to 90%
 Jahromi et al. [81] Meta-analysis 50% ≤ S < 70% 98 88 Standards for Reporting of Diagnostic Accuracy (STARD) criteria was used for the study
S ≥ 70% 90 94
 Wardlaw et al. [74] 916 (meta-analysis) 70% ≤ S ≤ 99% 89 84 Sensitivity—95% CI, 85% to 92% Specificity—95% CI, 77% to 89%