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Initial Exploration of the Value and the Influencing Factors of Color Doppler Flowing Imaging with the Three Kinds of Standards in Assessing the Degree of the Inter Carotid Artery Atherosclerotic Stenosis

Author: LiuShunLan
Tutor: ZhuJianPing
School: Fujian Medical
Course: Medical Imaging and Nuclear Medicine
Keywords: Internal carotid artery stenosis Doppler spectral imaging Color DopplerFlowing Imaging Digital Subtraction Angiography
CLC: R445.1
Type: Master's thesis
Year: 2012
Downloads: 24
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Objective:We evaluated the hemodynamic data of the internal carotid artery stenosis (ICAS)respectively on different sampling sites with the three different kind of Standards. Theaim of this study was to identify the objective and accurate method in assessing thedegree of ICAS by spectral Doppler ultrasound.Materials and Methods:60patients with symptom of cerebral ischemia (120arteries)were inspectedwith CDUS and DSA.The stemsons degree of each ICA was assessed bythree kinds of standards as follows: the standard recommended in2003of UltrasoundMedicine in American,the standard recommended in2006of Ultrasound in MedicineAustralia, the standard recommended by Ultrasound diagnosis Branch, XuanwuHospital, Capital University of Medical in2006.Taking DSA as the gold standard,this paper is to evaluate the diagnostic value of three kinds of Doppler hemodynamicparameters standards of the same internal carotid artery atherosclerotic stenosis(ICAS).2.Retrospective analysis: Recalling the ultrasound images of60patients withICA, all of the stenosis arteries were divided into three groups according to thesampling points of Doppler spectral: one group of arteries sampling site located inthe brightest color blood beam(Group A),the other group of arteries sampling sitelocated in the proximal part of the brightest color blood beam(Group B),another groupof artery sampling site located in the distal end of the brightest color bloodbeam(Group C).The stenosis degree of each ICA was assessed by the secondstandard and the diagnostic accordance rates of different groups were calculated. Perspective study:13patients (26ICA)suspected ICAS through carotid colorDoppler ultrasound (CDUS) were chosen. The samplings of Doppler spectrum werelocated on the brightest color blood beam (Group A’),the proximal part of thebrightest color blood beam(Group B’) and the distal end of the brightest color bloodbeam (Group C’)respectively. According to the sampling site Hemodynamicsparameters as PSVICA, EDVICA were divided into three groups (A ’, B ’, C ’Group)and the medium value of each parameter were calculated.Results:1.The results of coincidence tests shows that all assessment results of these threekinds of standards had similarity to DSA(P<0.001).The result of the second standardhas the highest overall similarity to DSA(k=0.76). Three kinds of standards forassessing ICAS receiver-operator characteristic(ROC) shows the area under curves(AUC) of three standards ROC,comparing to the opportunity curve (0.5),has asignificant difference(P<0.05).The sensitivity(64.00%、81.25%) and accuracy(89.17%、96.67%)for diagnosing50%-69%and70%-99%stenoses are both higherthan other two standards.2. Results of retrospective analysis: Through assessing the ICAS by the parameterstandard recommended in the2006of Ultrasound in Medicine Australia, theconclusion comes that the diagnostic accordance rate of group A (the Dopplersampling located in the brightest color blood beam)has significant difference (P=0.001), comparing with group B and C.Results of prospective study:By comparing group B’ and group C’ with group A’,the medium value of PSVICA and the medium value of EDVICA show nodifference.(P>0.05)Conclusion:1. According to the preliminary study, all of these three kinds of standards areeffective in assessing the stenosis degree of ICA. The standard recommended in the2006of Ultrasound in Medicine Australia may be superior to other two standards inthe effectiveness of the diagnosis of moderate and critical stenoses(50%-69%and 70%-99%). But it’s necessary to make further study by expanding samples.2. Doppler sampling site is an important factor that affects the accuracy of Dopplerhemodynamic parameters standards assessing the degree of ICA stenosis. This studysuggests that the sampling site of the Doppler spectrum should be located on thebrightest site of color blood beam.And then the Influence of the assessmentaccuracy of artery stenosis dued to inaccuracy of measurement should be avoided.

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