Carotid Atherosclerotic Stenosis: Correlation Of Sonography And Digital Subtraction Angiography In The Diagnosis

BACKGROUND:About detection of carotid diseases,Duplex sonography have been the first choice gradually,because advantages of noninvasive,simple-procedure,convenience,repeatability,actual-imaging,direct-viewing,cheap,safety.About whether or not concluding appropriate therapeutic-measure on the base of Duplex sonographic consequence,and accuracy of diversified diagnostic criteria. All theses are hot spot of correlative sciences.PURPOSE:(1)To study dependability of scleratheroma plaque echofeature and cerebral ischemia symptoms.(2)To study Correlation of Sonography and Digital Subtraction Angiography in the diagnosis of plaque-ulcus.(3)According to results of angiography and hemodynamic parameter of ultrasound to found optimal thresholds of carotid stenosis' degree.METHODS:135consecutive patients with ischemic cerebrovascular disease from January 2006 to Marth 2008 were cheked with serial US and DSA.Inspection item of US including:plaques' size,echo and ulcus. The hemodynamic parameter of ultrasound:peak systolic velocity(PSV), end-diastolic velocity(EDV),and internal carotid artery to common carotid velocity ratio(ICA/CCA ratio).To calculate rate of stenosis by NASCET criteria(North American Symptomatic Carotid Endarterectomy Trial).Then get gram of inear regression of stenosis rate and PSV,stenosis rate and EDV,stenosis rate and(ICA/CCA ratio)by using SPSS statistical software.RESULTS:(1)The cases'number of low echo-level plaque,equal echo plaque,high-level echo plaque,inhomogeneous echo plaque is 20,5,26,44 in cerebral ischemia patients和6,6,27,1 in cerebral non-ischemia patients.(2)The cases' number of plaques' ulcus is 31 by DSA diagnostic-criteria and 34 by ultraphonic diagnostic-criteria.(3)PSV_ICA≥145cm/s,EDV_ICA≥40cm/s,PSV_ICA/PSV_CCA≥2.0 are optimal thresholds for≥50%stenotic arteries,PSV_ICA≥250cm/s,EDV_ICA≥88cm/s,PSV_ICA /PSV_CCA3.6 are optimal thresholds for≥70%stenotic arteries.CONCLUSIONS:(1)The percentage of high-level echo,inhomogeneous echo in cerebral ischemia patients and cerebral non-ischemia patients have conspicuous statistical difference,inhomogeneous echo plaque is cause to stoke.(2)The percentage of plaques' ulcus by DSA diagnostic -criteria and ultraphonic diagnostic-criteria have not conspicuous statistical difference.(3)PSV_ICA,EDV_ICA,PSV(ICA)/PSV_CCAare the accurate hemodynamic parameters in assessing the severity of carotid stenosis.