Value of Transcranial Doppler Ultrasound in the Assessment of Haemodynamic Changes in the Middle Cerebral Artery and Collateral Circulation Due to Severe Stenosis of the Internal Carotid Artery
Objective To investigate the value of transcranial Doppler ultrasound(TCD)in assessing the hemodynamic changes of the middle cerebral artery and collateral circulation caused by severe stenosis of the internal carotid artery.Methods A total of 96 patients with internal carotid artery stenosis in Luoyang Central Hospital from October 2020 to October 2022 were selected as the study objects.According to the results of digital subtraction angiography(DSA),they were divided into mild stenosis,moderate stenosis and severe stenosis.TCD was used to measure the cerebral arterial hemodynamics parameters[velocity systolic(Vs),pulse index(PI),cerebrovascular reserve(CVR)],and analyzed the correlation and evaluation value between the cerebral arterial hemodynamics parameters and the degree of internal carotid artery stenosis.The hemodynamic parameters of cerebral arteries and the detection rates of DSA and TCD in patients with and without open collateral circulation were compared.Results The comparison of Vs,PI and CVR in patients with different internal carotid artery stenosis was as follows:severe stenosis＜moderate stenosis＜mild stenosis(P＜0.05).The correlation analysis showed that the blood flow parameters Vs,PI and CVR were negatively correlated with the degree of internal carotid artery stenosis(P＜0.05).The area under curve(AUC)of Vs,PI and CVR for mild and moderate internal carotid artery stenosis was 0.798,0.763 and 0.854,respectively.The AUC of combined diagnosis was 0.893,the AUC of mild,moderate and severe internal carotid artery stenosis was 0.832,0.795 and 0.856,respectively.The AUC of combined diagnosis was 0.927.Compared with patients without collateral circulation,patients with collateral circulation had higher Vs,PI and CVR(P＜0.05).There was no significant difference between TCD and DSA in the detection rate of collateral circulation opening(P＞0.05).Conclusion TCD can evaluate the hemodynamic changes of cerebral middle arteries caused by severe internal carotid artery stenosis,and provide reference for early diagnosis of internal carotid artery stenosis and establishment of collateral circulation,so as to make targeted treatment and improve prognosis.
transcranial Doppler ultrasoundsevere internal carotid artery stenosisarterial hemodynamics in the braincollateral circulation
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