PurposeThe acceleration time (AcT) ratio of the internal carotid artery (ICA) is increased in ICA stenosis. However, there are few reports that have directly compared the AcT ratio to digital subtraction angiography (DSA) findings.MethodsWe evaluated 177 vessels with DSA and carotid artery ultrasonography. The AcT ratio was calculated as AcT of the ICA (ICA–AcT)/AcT of the ipsilateral common carotid artery (CCA). We evaluated the correlation of DSA–NASCET stenosis with the origin of the ICA or the peak systolic velocity (ICApsv) in the stenotic region, ICApsv/peak systolic velocity of the CCA (CCApsv), ICA–AcT, and AcT ratio. Sensitivity and specificity for stenosis ≥ 70% were calculated based on the ICApsv, ICApsv/CCApsv, ICA–AcT, and AcT ratio.ResultsUsing NASCET criteria, 34 vessels had 70% or greater stenosis. DSA–NASCET showed a significant positive correlation with ICApsv, ICApsv/CCApsv, ICA–AcT, and AcT ratio (p < 0.0001). When the cut-off value for ICApsv was set at 176 cm/s, ICApsv/CCApsv at 2.42, ICA–AcT at 0.095 s, and the AcT ratio at 1.35, the sensitivity was 97.1, 97.1, 82.4, and 97.1%, and the specificity was 94.4, 91.0, 83.2, and 83.2%, for DSA–NASCET ≥ 70%, respectively.ConclusionThe AcT ratio is a beneficial parameter for evaluating ICA stenosis as well as ICApsv and ICApsv/CCApsv.
We identified current smoking and hypertension as the most significant contributing factors to increased IMT-C in residents of Tochigi Prefecture, emphasizing the importance of routine blood pressure monitoring and anti-smoking education in this population.
Objective: The jet flow direction at the stenotic lesion is not always parallel to the blood vessel direction. Therefore, we examined the optimal angle correction. Methods: Among 50 subjects with stenosis at the internal carotid artery (ICA) bifurcation who underwent carotid ultrasonography and digital subtraction angiography (DSA). The measurement of peak systolic velocity (PSV) at the stenotic lesion site was performed according to the guideline of Japan Academy of Neurosonology. The subjects were divided into 2 groups: group A, angle was aligned parallel to the blood flow at the stenotic lesion (n = 23) and group B, angle was aligned parallel to the blood vessel (n = 30). ICA stenosis was diagnosed on DSA images according to NASCET criteria. Results: In groups A and B, there was a significant correlation between PSV and stenosis ratio. In diagnosing ICA stenosis (≥ 70%), the area under ROC curve, the sensitivity and specificity of PSV were 0.973, 100% and 85.7% with a cutoff level of 203.5 cm/s and 0.765, 70.0% and 80.0% with a cutoff level 256.9 cm/s, respectively. Conclusion: Our study suggests the angle-adjustment towards the blood flow at the stenotic lesion site is superior to the angle-adjustment parallel to the blood vessel for PSV measurement.
Objectives: The jet flow direction at the stenotic lesion is not always parallel to the blood vessel direction. Methods: A total of 50 vessels with stenosis at the origin of internal carotid artery (ICA) were evaluated with carotid ultrasonography and digital subtraction angiography (DSA). The peak systolic velocity (PSV) was measured by pulsed wave Doppler (PWD). The vessels were divided into 2 groups: group A, angle of PWD was aligned parallel to the blood flow at the stenotic lesion (n523) and group B, angle was aligned parallel to the blood vessel (n530). Three vessels were evaluated with both methods applied to group A and B. Simple regression analysis was used to examine the relationship between the PSV and ICA stenosis. The receiver operating characteristic (ROC) curve was used to calculate the optimal cutoff values of the PSV for ICA stenosis ($ 70%). Results: In groups A and B, there was a significant correlation between PSV and NASCET stenosis ratio. In diagnosing ICA stenosis ($ 70%), the area under ROC curve, the sensitivity and specificity of PSV were 0.973, 100% and 85.7% with a cutoff level of 203.5 cm/s and 0.765, 70.0% and 80.0% with a cutoff level 256.9 cm/s, respectively. Conclusions: Our study suggests the angle-adjustment towards the blood flow at the stenotic lesion site is superior to the angle-adjustment parallel to the blood vessel for PSV measurement.
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