Document Detail


Evaluation of distal turbulence intensity for the detection of both plaque ulceration and stenosis grade in the carotid bifurcation using clinical Doppler ultrasound.
MedLine Citation:
PMID:  23247808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the interrelationship of stenosis grade and ulceration with distal turbulence intensity (TI) in the carotid bifurcation measured using conventional clinical Doppler ultrasound (DUS) in vitro, in order to establish the feasibility of TI as a diagnostic parameter for plaque ulceration.
METHODS: DUS TI was evaluated in a matched set of ulcerated and smooth-walled carotid bifurcation phantoms with various stenosis severities (30, 50, 60 and 70 %), where the ulcerated models incorporated a type 3 ulceration.
RESULTS: Post-stenotic TI was significantly elevated owing to ulceration in the mild and moderate stenoses (P < 0.001). TI increased with stenosis severity in both the ulcerated and non-ulcerated series, with a statistically significant effect of increasing stenosis severity (P < 0.001). Whereas TI in the mild and non-ulcerated moderate stenoses was less than 20.4 ± 1.3 cm s(-1), TI in the ulcerated moderate and severe models was higher than 25.6 ± 1.3 cm s(-1), indicating a potential diagnostic threshold.
CONCLUSION: We report a two-curve relationship of stenosis grade and ulceration to distal TI measured using clinical DUS in vitro. Clinical DUS measurement of distal TI may be a diagnostic approach to detecting ulceration in the mild and moderately stenosed carotid artery.
KEY POINTS: • Patients with carotid artery plaque ulcerations are at higher risk of stroke. • Clinical Doppler ultrasound is routinely used to detect carotid artery stenosis. • Doppler ultrasound turbulence intensity can detect ulceration in realistic flow models. • Turbulence intensity also increases with stenosis severity independent of ulceration. • Doppler ultrasound should help in assessing both stenosis severity and ulceration.
Authors:
Emily Y Wong; Hristo N Nikolov; Richard N Rankin; David W Holdsworth; Tamie L Poepping
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-12-18
Journal Detail:
Title:  European radiology     Volume:  23     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-17     Completed Date:  2013-12-26     Revised Date:  2014-08-26    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1720-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Angiography / methods
Anthropometry
Blood Flow Velocity
Carotid Arteries / pathology,  ultrasonography*
Carotid Artery, Internal / pathology,  ultrasonography
Carotid Stenosis / pathology,  ultrasonography*
Constriction, Pathologic
Humans
Phantoms, Imaging
Reproducibility of Results
Risk Factors
Time Factors
Ultrasonography, Doppler / methods*
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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