Non-invasive vascular assessment in the foot with diabetes: sensitivity and specificity of the ankle brachial index, toe brachial index and continuous wave Doppler for detecting peripheral arterial disease

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• 作者：Peta Ellen Tehan^a ; ^{peta.craike@newcastle.edu.au" class="auth_mail" title="E-mail the corresponding author} ; Alan Bray^b ; Vivienne Helaine Chuter^a
• 关键词：Continuous wave Doppler ; Ankle&ndash ; Brachial index ; Toe&ndash ; Brachial index ; Sensitivity ; Specificity ; Peripheral arterial disease
• 刊名：Journal of Diabetes and its Complications
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：30
• 期：1
• 页码：155-160
• 全文大小：375 K

文摘

Non-invasive lower limb vascular assessment in people at risk of peripheral arterial disease (PAD) including those with diabetes is crucial. There is evidence that standard assessment techniques such as the ankle–brachial index (ABI) may be less effective in people with diabetes. However there is limited evidence for other frequently used tests including continuous wave Doppler (CWD), and the toe–brachial index (TBI). The aim of this study was to determine the sensitivity and specificity of, ABI, CWD and TBI in a population with, and without diabetes.

Methods

Participants with and without diabetes who met current guidelines for vascular screening were recruited, and CWD waveforms, an ABI and a TBI were obtained from the right lower limb. Diagnostic accuracy was determined using colour duplex ultrasound (CFDU). Receiver operating characteristic curves were calculated.

Results

117 participants were recruited, seventy-two with diabetes and forty-five without diabetes. CWD had the highest sensitivity in people with diabetes (74%) and without (84%). CWD also had the highest specificity in people with diabetes (74%) and without (84%) compared to both TBI and ABI. In participants with diabetes, the ABI was a poor test, area under the curve: 0.58 (p = 0.27).

Conclusions

CWD waveform is more likely to detect significant PAD compared to ABI and TBI in people with and without diabetes.