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European Radiology
Published in: European Radiology 8/2016

Open Access 01-08-2016 | Vascular-Interventional

Reproducibility of the SPI-US protocol for ultrasound diameter measurements of the Posterior Circumflex Humeral Artery and Deep Brachial Artery: an inter-rater reliability study

Authors: Daan van de Pol, Sena Alaeikhanehshir, P. Paul F. M. Kuijer, Aart Terpstra, Marja J. C. Pannekoek-Hekman, R. Nils Planken, Mario Maas

Published in: European Radiology | Issue 8/2016

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Abstract

Objectives

Elite overhead athletes are at risk of posterior circumflex humeral artery (PCHA) degeneration, aneurysm formation and thrombosis. Identification of the proximal PCHA and the nearby originating deep brachial artery (DBA) can be a challenge, even among experienced sonographers. The aim of this study was to assess the accuracy and precision of a newly designed standardized ultrasound (US) protocol (SPI-US) for assessment of the PCHA and DBA.

Methods

Two experienced sonographers determined diameters of the PCHA and DBA using the SPI-US protocol. Inter-observer agreement was evaluated using intra-class correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), Bland-Altman (BA) analysis, and variance component (VARCOMP) analysis.

Results

Thirty-three healthy volunteers participated. The ICC for diameter measurement of the PCHA and DBA were 0.70 (95 %CI 0.50-0.83) and 0.60 (95 %CI 0.30-0.80), respectively. The SEM for the PCHA and DBA was 0.32 mm and 0.29 mm and MDC was 0.90 mm and 0.80 mm, respectively. The BA and VARCOMP analyses showed no systematic and only marginal sonographer bias.

Conclusions

The SPI-US protocol is accurate and precise for PCHA and DBA diameter assessment in cases where they originate from the axillary artery. PCHA and DBA diameter measurements are sonographer-independent using the SPI-US-protocol.

Key points

• PCHA & DBA diameter assessment is accurate and reliable using the SPI-US protocol
• PCHA & DBA diameter measurements are sonographer-independent using the SPI-US protocol
• The SPI-US protocol minimal detectable change is 0.90 mm for PCHA diameter measurement
• This minimal detectable change enables detection of PCHA aneurysms
• First step towards international periodic surveillance of athletes at risk of PCHA-injury
Literature
1.
van de Pol D, Kuijer PPFM, Langenhorst T, Maas M (2012) High Prevalence of Self-Reported Symptoms of Digital Ischemia in Elite Male Volleyball Players in the Netherlands A Cross-Sectional National Survey. Am J Sports Med 40:2296–2302CrossRefPubMed
2.
Atema JJ, Ünlü Ç, Reekers JA, Idu MM (2012) Posterior Circumflex Humeral Artery Injury with Distal Embolisation in Professional Volleyball Players: a Discussion of Three Cases. Eur J Vasc Endovasc Surg 44:195–198CrossRefPubMed
3.
Vlychou M, Spanomichos G, Chatziioannou A et al (2001) Embolisation of a traumatic aneurysm of the posterior circumflex humeral artery in a volleyball player. Br J Sports Med 35:136–137CrossRefPubMedPubMedCentral
4.
Reekers JA, den Hartog BM, Kuyper CF et al (1993) Traumatic aneurysm of the posterior circumflex humeral artery: a volleyball player’s disease? J Vasc Interv Radiol 4:405–408CrossRefPubMed
5.
Arko FR, Harris EJ, Zarins CK, Olcott C (2001) Vascular complications in high-performance athletes. J Vasc Surg 33:935–942CrossRefPubMed
6.
Stänz K, Wedler V, Köpfli P et al (2001) Compression syndrome of the arteria circumflexa humeri posterior in a volleyball player. Vasa 30:229–232CrossRefPubMed
7.
Brown S-AN, Doolittle DA, Bohanon CJ et al (2015) Quadrilateral Space Syndrome. Mayo Clin Proc 90:382–394CrossRefPubMed
8.
9.
Ndoye JM, Armstrong O, Rogez JM et al (2002) Update on lateral and medial spaces of the dorsal wall of the axillary fossa] [article in French. Dakar Med 47:188–193PubMed
10.
McClelland D, Paxinos A (2008) The anatomy of the quadrilateral space with reference to quadrilateral space syndrome. J Shoulder Elb Surg 17:162–164CrossRef
11.
Hattori Y, Doi K, Sakamoto S, Satbhai N (2013) Anatomic Variations in Branching Patterns of the Axillary Artery: a Multidetector-Row Computed Tomography Angiography Study. J Reconstr Microsurg 29:531–536CrossRefPubMed
12.
Olinger A, Benninger B (2010) Branching patterns of the lateral thoracic, subscapular, and posterior circumflex humeral arteries and their relationship to the posterior cord of the brachial plexus. Clin Anat 23:407–412CrossRefPubMed
13.
Bagoji IB, Hadimani GA, Bannur BM et al (2013) A Unique Branching Pattern of the Axillary Artery: a Case Report. J Clin Diagn Res 7:2939–2940PubMedPubMedCentral
14.
Çavdar S, Zeybek A, Bayramicli M (2000) Rare variation of the axillary artery. Clin Anat 13:66–68CrossRefPubMed
15.
Naveen K, Jyothsna P, Nayak SB et al (2014) Variant Origin of an Arterial Trunk from Axillary Artery Continuing as Profunda Brachii Artery-A Unique Arterial Variation in the Axilla and its Clinical Implications. Ethiop J Health Sci 24:93CrossRefPubMedPubMedCentral
16.
van de Pol D, Maas M, Alaeikhanehshir S, et al (2015) B-mode ultrasound assessment of the posterior circumflex humeral artery - the SPI-US protocol: a technical procedure in 4-steps. J Ultrasound Med. doi:10.​7863/​ultra.​15.​05037
17.
Robinson DJ, Marks P, Schneider-Kolsky ME (2010) Ultrasound of the posterior circumflex humeral artery. J Med Imaging Radiat Oncol 54:219–223CrossRefPubMed
18.
Robinson DJ, Marks P, Schneider-Kolsky ME (2011) Occlusion and stenosis of the posterior circumflex humeral artery: detection with ultrasound in a normal population. J Med Imaging Radiat Oncol 55:479–484CrossRefPubMed
19.
Johnston KW, Rutherford RB, Tilson MD, Shah DM, Hollier L, Stanley JC (1991) Suggested standards for reporting on arterial aneurysms. J Vasc Surg 13:452–458
20.
Planken RN, Keuter XH a, Hoeks APG et al (2006) Diameter measurements of the forearm cephalic vein prior to vascular access creation in end-stage renal disease patients: graduated pressure cuff versus tourniquet vessel dilatation. Nephrol Dial Transplant 21:802–806CrossRefPubMed
21.
Planken RN, Keuter XH, Kessels AG et al (2006) Forearm cephalic vein cross-sectional area changes at incremental congestion pressures: towards a standardized and reproducible vein mapping protocol. J Vasc Surg 44:353–358CrossRefPubMed
22.
Fleiss JL (1999) Repeated Measurements Studies. Des. Anal. Clin. Exp. John Wiley & Sons, Inc., In, pp 220–240
23.
de Vet HCW, Terwee CB, Mokkink LB, Knol DL (2011) Measurement in Medicine: A Practical Guide. Cambridge University Press, CambridgeCrossRef
24.
Gellhorn AC, Carlson MJ (2013) Inter-Rater, Intra-Rater, and Inter-Machine Reliability of Quantitative Ultrasound Measurements of the Patellar Tendon. Ultrasound Med Biol 39:791–796CrossRefPubMed
25.
Grams ST, von Saltiél R, Mayer AF et al (2014) Assessment of the reproducibility of the indirect ultrasound method of measuring diaphragm mobility. Clin Physiol Funct Imaging 34:18–25CrossRefPubMed
26.
Kalashyan H, Shuaib A, Gibson PH et al (2014) Single sweep three-dimensional carotid ultrasound: reproducibility in plaque and artery volume measurements. Atherosclerosis 232:397–402CrossRefPubMed
27.
Lindholt JS, Vammen S, Juul S et al (1999) The Validity of Ultrasonographic Scanning as Screening Method for Abdominal Aortic Aneurysm. Eur J Vasc Endovasc Surg 17:472–475CrossRefPubMed
28.
Pleumeekers HJCM, Hoes AW, Mulder PGH et al (1998) Differences in observer variability of ultrasound measurements of the proximal and distal abdominal aorta. J Med Screen 5:104–108CrossRefPubMed
Metadata
Title
Reproducibility of the SPI-US protocol for ultrasound diameter measurements of the Posterior Circumflex Humeral Artery and Deep Brachial Artery: an inter-rater reliability study
Authors
Daan van de Pol
Sena Alaeikhanehshir
P. Paul F. M. Kuijer
Aart Terpstra
Marja J. C. Pannekoek-Hekman
R. Nils Planken
Mario Maas
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4110-8

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