Clinical Values In Patients With The Middle Cerebral Artery Atherosclerosis Cerebral Infarction With Transcranial Color-code Sonography Combined With Carotid Duplex Ultrasound

Objective: Intracranial atherosclerosis is the important pathogenesis of cerebralinfarction. It focuses to appraise accurately the range of arterial stenosis, the degree ofarterial lesions and hemodynamic changes, which is vital to patients with intracranialatherosclerotic cerebral infarction and relates to pathogenesis, treatment and prognosis.There were lots of reports about carotid duplex ultrasound assessing carotid or transcranialcolor-code sonography assessing intracranial artery in patients with intracranialatherosclerosis， but few reports assessed intracranial atherosclerosis combined both ofthem. The middle cerebral artery (MCA) is most likely occurred and with the highestsensitivity and specificity by transcranial color-code sonography (TCCS). We studiedpatients with MCA atheroscerosis cerebral infarction with TCCS combined with carotidduplex ultrasound to appraise it’s clinical values.Methods: We selected seventy-five patients with MCA atherosclerosiscerebral infarction who were affirmed by CT angiography (CTA) and40healthy controlswith matched age and sex.All of patients with cerebral infarction were examined with TCCS and carotid dulplexultrasound by the same doctor in turn in a week. The systolic velocity (Vs), the diastolicvelocity (Vd), the pulsatility index(PI) and the resistance index (RI) of both side of MCAwere noted with TCCS. The systolic diameter (Ds) of the common carotid artery(CCA),the average of intima-media thickness (IMT) were measured with carotid duplexultrasound. We watched whether there were plaques, and noted the echo, the number of theplaques and the number of vessels which were occurred by plaques.Results: In the group of patients with cerebral infarction, the Ds and IMT of CCA,the RI and PI of MCA were not significantly different between the CTA positive side and negative side (P>0.05). The incidence rate of plaques, the checking rate of mixed-echo andlower-echo plaques and the rate of multiple plaques were higher in bilateral CCA werenot significantly different side (P>0.05).The Ds and IMT of bilateral CCA in the group of patients with cerebral infarctionwere larger than that in the control group (P <0.05). The RI and PI of bilateral MCA in thegroup of patients with cerebral infarction were higher than that in the control group (P <0.05). The incidence rate of plaques, the checking rate of mixed-echo and lower-echoplaques and the rate of multiple plaques in bilateral CCA in the group of patients withcerebral infarction were higher than that in the control group(P <0.05).In seventy-five patients with cerebral infarction, the Vs of MCA of the CTA positiveside was abnormally increased in twenty-one patients (28%), decreased in forty-twopatients (26%) and was in normal range in twelve patients (16%). The abnormal rate ofblood flow velocity was by84%with TCCS.Conclusion: The Ds, the IMT, the incidence rate of plaques, the checking rate ofmixed-echo and lower-echo plaques and the rate of multiple plaques of bilateral CCAwere the same in the same patient with the MCA atherosclerosis cerebral infarction, whichindicate that the progress of atherosclerosis of bilateral CCA was the same in the samegroup. When lower-echo plaques and mixed-echo plaques are found in each side of carotidartery, we must begin treatment for stable plaques and anti atherosclerosis. We can obtainMCA sonography about its blood flow direction and hemodynamic parameters of thestenosis and its proximal or distal end, which can assist doctors for early diagnosis ofintracranial atherosclerotic stenosis and saving valuable time for treatment and improvingprognosis.