Evaluation of Carotid Stenosis in a High-Stroke-Risk Population by Hemodynamic Dual-Parameters Based on Ultrasound Vector Flow Imaging

IF 2.6 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior Pub Date : 2024-11-17 DOI:10.1002/brb3.70150

Shaofu Hong, Yinghui Dong, Wenjing Gao, Di Song, Mengmeng Liu, Weiyue Li, Yigang Du, Jinfeng Xu, Fajin Dong

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Abstract

Objective

This study explored the feasibility of using high-frame-rate ultrasound vector flow imaging (VFI) to quantitatively assess hemodynamics in atherosclerotic internal carotid artery stenosis (ICAS) by evaluating dual-parameters, turbulence index (Tur), and wall shear stress (WSS). Their efficacy in evaluating carotid artery stenosis was also analyzed.

Methods

Fifty-nine patients with ICAS were enrolled. B-mode ultrasound and V Flow (a high-frame-rate VFI) were performed using the Resona R9 system. The stenosis rate was measured in grayscale mode, whereas the time-averaged Tur index, the time-averaged WSS (WSS_mean), and maximum WSS (WSS_max) around stenosis were measured. The combined diagnostic efficacy of Tur inand WSS was also investigated.

Results

Compared to proximal to stenosis (Tur index, 2.88% ± 3.65%), highly disordered blood flow was observed in the stenotic (23.17% ± 15.52%, p < 0.001) and distal segment (25.86% ± 17.29%, p < 0.001). WSS_max ([11.91 ± 6.73] vs. [4.43 ± 5.4] Pa, p < 0.001) and WSS_mean ([3.42 ± 2.67] vs. [0.86 ± 1.21] Pa, p < 0.001) were significantly bigger in stenotic than those in the distal segment. The differences in the ratio WSS_max/Tur or WSS_mean/Tur among different segments around stenosis were statistically significant (p < 0.001). The combination of Tur index and WSS had the best diagnostic performance in ICAS (AUC, 0.899).

Conclusion

The application of Tur index and WSS for quantitative assessment of ICAS hemodynamic changes is feasible, with the combined evaluation of these two parameters providing incremental diagnostic value for carotid artery stenosis. VFI-based dual quantitative parameters may offer promising noninvasive diagnostic tools for carotid artery stenosis in high-stroke-risk populations.

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基于超声矢量血流成像的血液动力学双参数评估中风高危人群的颈动脉狭窄情况

研究目的本研究通过评估湍流指数（Tur）和壁剪切应力（WSS）这两个参数，探讨了使用高帧率超声矢量流成像（VFI）定量评估动脉粥样硬化性颈内动脉狭窄（ICAS）血流动力学的可行性。还分析了它们在评估颈动脉狭窄方面的功效：方法：59 名 ICAS 患者入选。使用 Resona R9 系统进行 B 型超声和 V Flow（一种高帧率 VFI）检查。以灰度模式测量狭窄率，同时测量时间平均 Tur 指数、时间平均 WSS (WSSmean) 和狭窄周围最大 WSS (WSSmax)。此外，还研究了 Tur in 和 WSS 的综合诊断效果：结果：与狭窄近端相比（Tur 指数，2.88% ± 3.65%），狭窄处血流高度紊乱（23.17% ± 15.52%，p 最大值（[11.91 ± 6.73] vs. [4.43 ± 5.4] Pa，p 平均值（[3.42 ± 2.67] vs. [0.86 ± 1.21] Pa，p 最大值/Tur 或 WSSmean/Tur）在狭窄周围不同节段之间均有统计学意义（p 结论：Tur 指数和 WSSmean 的应用对血管狭窄的诊断具有重要意义：应用 Tur 指数和 WSS 对 ICAS 血流动力学变化进行定量评估是可行的，这两个参数的联合评估为颈动脉狭窄提供了更高的诊断价值。基于 VFI 的双重定量参数可为高卒中风险人群的颈动脉狭窄提供有前景的无创诊断工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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