Carotid near-occlusion frequently has high peak systolic velocity on Doppler ultrasound.

Autor: Khangure SR; Department of Medical Imaging, Neuroradiology Division, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. simon.khangure@health.wa.gov.au.; Department of Medical Imaging, Division of Neuroimaging, University of Toronto, Toronto, Canada. simon.khangure@health.wa.gov.au., Benhabib H; Department of Medical Imaging, Neuroradiology Division, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada., Machnowska M; Department of Medical Imaging, Neuroradiology Division, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.; Department of Medical Imaging, Division of Neuroimaging, University of Toronto, Toronto, Canada., Fox AJ; Department of Medical Imaging, Neuroradiology Division, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.; Department of Medical Imaging, Division of Neuroimaging, University of Toronto, Toronto, Canada., Grönlund C; Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden., Herod W; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada., Maggisano R; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada.; Division of Vascular Surgery, Department of Surgery, University of Toronto, Toronto, Canada., Sjöberg A; Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden.; Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden., Wester P; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.; Department of Clinical Sciences, Karolinska Institutet Danderyds Hospital, Stockholm, Sweden., Hojjat SP; Department of Medical Imaging, Neuroradiology Division, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.; Department of Medical Imaging, Division of Neuroimaging, University of Toronto, Toronto, Canada., Hopyan J; Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada., Aviv RI; Department of Medical Imaging, Neuroradiology Division, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.; Department of Medical Imaging, Division of Neuroimaging, University of Toronto, Toronto, Canada., Johansson E; Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Jazyk: angličtina
Zdroj: Neuroradiology [Neuroradiology] 2018 Jan; Vol. 60 (1), pp. 17-25. Date of Electronic Publication: 2017 Nov 25.
DOI: 10.1007/s00234-017-1938-4
Abstrakt: Purpose: Carotid near-occlusion is a tight atherosclerotic stenosis of the internal carotid artery (ICA) resulting in decrease in diameter of the vessel lumen distal to the stenosis. Near-occlusions can be classified as with or without full collapse, and may have high peak systolic velocity (PSV) across the stenosis, mimicking conventional > 50% carotid artery stenosis. We aimed to determine how frequently near-occlusions have high PSV in the stenosis and determine how accurately carotid Doppler ultrasound can distinguish high-velocity near-occlusion from conventional stenosis.
Methods: Included patients had near-occlusion or conventional stenosis with carotid ultrasound and CT angiogram (CTA) performed within 30 days of each other. CTA examinations were analyzed by two blinded expert readers. Velocities in the internal and common carotid arteries were recorded. Mean velocity, pulsatility index, and ratios were calculated, giving 12 Doppler parameters for analysis.
Results: Of 136 patients, 82 had conventional stenosis and 54 had near-occlusion on CTA. Of near-occlusions, 40 (74%) had high PSV (≥ 125 cm/s) across the stenosis. Ten Doppler parameters significantly differed between conventional stenosis and high-velocity near-occlusion groups. However, no parameter was highly sensitive and specific to separate the groups.
Conclusion: Near-occlusions frequently have high PSV across the stenosis, particularly those without full collapse. Carotid Doppler ultrasound does not seem able to distinguish conventional stenosis from high-velocity near-occlusion. These findings question the use of ultrasound alone for preoperative imaging evaluation.
Databáze: MEDLINE
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