Assessment of carotid arteries in stroke patients by ultrasonography and color Doppler

Authors

  • Shenaz G. A. Saifi Department of Radiology, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
  • Vikash Rustagi Department of Radiology, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
  • Dev Shetty Department of Radiology, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20223251

Keywords:

Stroke, Carotid atherosclerosis, Imaging techniques, Ultrasonography, Color Doppler, Plaques

Abstract

Background: Prevalence and associated mortality and morbidity rates apprehend stroke as a major health concern worldwide. Atherosclerotic disease of carotid arteries is the most common source of stroke. Quick and effective diagnosis, management and treatment of stroke is essential. Conventional diagnostic imaging techniques lacks the efficacy to rapidly and accurately dragonize stroke. Current investigation is focused towards assessing carotid arteries in stroke patients by ultrasonography and color Doppler to study the locate and study the morphology of lesion in carotid artery and to grade severity and extent of stenosis.

Methods: A prospective observational study was performed on stroke patients of more than 40 years of age. The study was conducted at the department of radio diagnosis in a tertiary care center for a period of 18 months. Varied color Doppler parameters were studied and optimized to assess the morphology and surface of plaques and to determine stenosis

Results: Mean age of the patients with carotid lesion was observed to be 59.7±9.8 years and male patients outnumbered postmenopausal female patients. Hemiparesis was the most common clinical presentation. Majority of patients exhibited raised intimomedial thickness and single or multiple plaques commonly in carotid bulb. Plaques of type II with irregular surface were most commonly observed which exhibited mostly 50-69% stenosis.

Conclusions: The carotid artery embolic occlusion stenosis is the primary cause of stroke. Doppler sonography provides a rapid, noninvasive, relatively inexpensive and accurate means of diagnosing carotid stenosis, to determine the degree of cervical carotid stenosis and plaque morphology.

References

Murphy SJ, Werring DJ. Stroke: causes and clinical features. Medicine (Abingdon). 2020;48(9):561-6.

Kuriakose D, Xiao Z. Pathophysiology and treatment of stroke: present status and future perspectives. Int J Mol Sci. 2020;21(20):7609.

Eliasziw M, Kennedy J, Hill MD, Buchan AM, Barnett HJM. Early risk of stroke after a transient ischemic attack in patients with internal carotid artery disease. Can Med Assoc J. 2004;170:1105-9.

Fisher M, Paganini-Hill A, Martin A, Cosgrove M, Toole JF, Barnett HJ, Norris J. Carotid plaque pathology: thrombosis, ulceration, and stroke pathogenesis. Stroke. 2005;36(2):253-7.

Yuan C, Mitsumori LM, Beach KW, Maravilla KR. Carotid atherosclerotic plaque: noninvasive MR characterization and identification of vulnerable lesions. Radiology. 2001;221(2):285-99.

Zwiebel WJ, John S. Pellerito Introduction to vascular ultrasonography. 5th ed. Netherlands: Elsevier. 2005;143-8.

Bots ML, Grobbee DE. Intima media thickness as a surrogate marker for generalised atherosclerosis. Cardiovasc Drugs Ther. 2002;16(4):341-51.

Gibbons GH, Dzau VJ. The emerging concept of vascular remodelling. N Engl J Med. 1994;330:1431-8.

Libby P. The fire within. Sci Am. 2002;286:46-55.

Ross R, Glomset JA. The pathogenesis of atherosclerosis. N Engl J Med.1976;295:369-77.

Ross R, Glomset JA. The pathogenesis of atherosclerosis. N Engl J Med. 1976;295:420-5.

Yew KS, Cheng E. Acute stroke diagnosis. Am Fam Physician. 2009;80(1):33-40.

Lee W. General principles of carotid Doppler ultrasonography. Ultrasonography. 2014;33(1):11-7.

Berman S, Devme J, Erodes L. Distinguishing carotid artery pseudo-occlusion with colour flow Doppler. Stroke. 1997;26:434-8.

Theile BL, Jones AM, Hobson RW. Standards in noninvasive cerebrovascular testing. report from the committee on standards for noninvasive testing of the joint council of the society for vascular surgery and the North American chapter of the international society for cardiovascular surgery. Vase Surg. 1992;15:495-503.

Lee TH, Ryu JE, Chen ST, Tseng KJ. Comparison between carotid duplex sonography and angiography in the diagnosis of extracranial internal carotid artery occlusion. Formosa Med Assoe. 1992;91;575-9.

Tahmasebpour HR, Buckley AR, Cooperberg PL, Fix CH. Sonographic examination of the carotid arteries. Radiographics. 2005;25(6):1561-75.

Abu-Rahma AF, Wulu JT, Crotty B. Carotid plaque ultrasonic heterogeneity and severity of stenosis. Stroke. 2002;33(7):1772-5.

Eliasziw M, Kennedy J, Hill MD, Buchan AM, Barnett HJM. Early risk of stroke after a transient ischemic attack in patients with internal carotid artery disease. Can Med Assoc J. 2004;170:1105-9.

Society for vascular ultrasound vascular technology professional performance guidelines extracranial cerebrovascular duplex ultrasound evaluation. Available at: https://www.svu.org/practice-resources/professional-performance-guidelines/. Accessed on 20 November 2021.

American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of an ultrasound examination of the extracranial cerebrovascular system. J Ultrasound Med. 2012;31(1):145-54.

Society for vascular technology professional standards committee image storage guideline. Available at: http://www.svtgbi.org.uk/assets/Uploads/News--PI/Final-SVT-Image-Storage-Guidelines-April-2012-PDF.pdf. Accessed on 20 November 2021.

Tegos TJ, Kalodiki E, Sabetai MM, Nicolaides AN. Strokepathogenesis, investigations and prognosis. Angiology. 2000;51:885-94.

Finucana FF, Madans JH, Bush TL, Wolf PH, Kleinman JC. Decreased risk of stroke among postmenopausal hormone users. Arch Inter Med. 1993;153:73-9.

Sultana N, Bari F, Majumder TK, Islam R, Hossain F, Alam F. duplex study of carotid artery in patients with ischemic stroke. Bangladesh J Neurosci. 2012;28(2):67-73.

Sethi SK, Solanki RS, Gupta H. Colour and duplex doppler imaging evaluation of extracranial carotid artery in patients presenting with transient ischemic attack and stroke: a clinical and radiological correlation. Indian J Radiol Imaging. 2005;15:91-8.

Malik R, Tiwari R. Carotid Doppler evaluation of transient ischemic attack and stroke patients and its correlation with CT scan head: a prospective study. J Dent Med Sci. 2013;7(1):20-5.

Firas LA, Noori A. Carotid Doppler study in patients with cerebral infarction. J Fac Med Baghdad. 2011;53:4.

Bluth El, Kay D, Merritt CR. Sonographic characterization of carotid plaque: detection of haemorrhage. Am J Roentgenol. 1986;146:1061-5.

Carroll BA. Duplex sonography in patients with hemispheric stroke symptoms. J Ultrasound Med. 1989;8:535-9.

Berman S, Devme J, Erodes L. Distinguishing carotid artery pseudo-occlusion with colour flow Doppler. Stroke. 1997;26:434-8.

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Published

2022-12-27

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Original Research Articles