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首页> 外文期刊>AJNR. American journal of neuroradiology >Transcranial color-coded duplex sonography for detection of distal internal carotid artery stenosis.
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Transcranial color-coded duplex sonography for detection of distal internal carotid artery stenosis.

机译：经颅彩色编码双工超声检查，用于检测远端颈内动脉狭窄。

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BACKGROUND AND PURPOSE: Gradation of high-grade intracranial internal carotid artery (ICA) stenosis poses a challenge to noninvasive neurovascular imaging, which seems critical for angioplasty in the ICA segments C1 and C5. We investigated cutoff values of intracranial ICA stenosis for transcranial color-coded sonography (TCCS) and compared this method with the "gold standard," digital subtraction angiography (DSA). Materials and METHODS: Forty patients (mean age, 58.9 +/- 13.8 years) with intracranial ICA lesions were prospectively examined by using TCCS and DSA. Two standard TCCS coronal imaging planes were used to evaluate the intracranial ICA. In addition, a control group of 128 volunteers without cerebrovascular disease (mean age, 48.8 +/- 15.9 years) was investigated to establish standard velocity values. RESULTS: DSA confirmed 96 stenoses and 8 occlusions of the intracranial ICA in the study population. In 9% and 7% of cases, stenosis confined to the C1 or C5 segment was >50% and 70%, respectively. Receiver-operating curves demonstrated cutoff values for >70% stenosis in C1 when the peak systolic velocity (PSV) was >200 cm/s (specificity, 100%; sensitivity, 71%) or the C1/submandibular ICA index was >3 (specificity, 93%; sensitivity, 86%). CONCLUSIONS: TCCS is a reliable adjunctive method to detect and quantify significant stenosis of the intracranial ICA. The assessment of the C1/ICA index and peak systolic velocities maximizes the diagnostic accuracy of C1 stenosis to >70% when extracranial ICA stenosis coexists. Further studies need to be performed to compare the diagnostic accuracies of MR angiography and TCCS with that of DSA.
机译：背景和目的：高级颅内颈内动脉（ICA）狭窄的分级对无创神经血管成像提出了挑战，这对于ICA段C1和C5的血管成形术至关重要。我们调查了颅内ICA狭窄用于经颅彩色编码超声检查（TCCS）的临界值，并将此方法与“黄金标准”数字减影血管造影术（DSA）进行了比较。材料和方法：采用TCCS和DSA前瞻性检查了40例颅内ICA病变患者（平均年龄58.9 +/- 13.8岁）。使用两个标准的TCCS冠状位成像平面评估颅内ICA。另外，对128名无脑血管疾病（平均年龄，48.8 +/- 15.9岁）的志愿者的对照组进行了研究，以建立标准速度值。结果：DSA证实了研究人群中96例狭窄和8例颅内ICA闭塞。在9％和7％的病例中，局限于C1或C5段的狭窄分别> 50％和70％。接受者操作曲线表明，当收缩压峰值速度（PSV）> 200 cm / s（特异性，100％;敏感性，71％）或C1 /下颌ICA指数> 3时，C1狭窄> 70％的临界值。特异性为93％;敏感性为86％）。结论：TCCS是一种可靠的辅助方法，可以检测和量化颅内ICA的明显狭窄。当颅外ICA狭窄共存时，对C1 / ICA指数和收缩期峰值速度的评估可使C1狭窄的诊断准确性最大化，达到> 70％。需要进行进一步的研究以比较MR血管造影和TCCS与DSA的诊断准确性。

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