[Correlation of duplex sonographic stenosis grading by means of cross-sectional analysis and MR-tomographic blood volume flow quantification in unilateral stenosis of the internal carotid artery].
OBJECTIVE
Correlation of duplex ultrasonographic grading of unilateral internal carotid artery (ICA) stenosis and ICA blood volume flow (BVF) quantification.


METHODS
Using a 2D cine phase-contrast MR technique, 62 patients with unilateral ICA stenosis at the level of the bifurcation between 50 % and 98 % and 20 age-matched normal controls were examined. BVF was measured in the stenosed ICA. Ultrasonographic grading of stenoses was based on cross-sectional duplex sonography (color Doppler flow imaging [CDFI], real-time compound imaging) and compared to the changes in BVF in the stenosed ICA.


RESULTS
There was no statistically significant difference in BVF in stenoses of the ICA up to 70 % and in normal controls. ICA stenoses greater 70 % began to be hemodynamically relevant. With increasing stenosis, a decrease in BVF in the ipsilateral ICA was determined with a high and linear correlation of r = - 0.83. Normal controls showed a BVF in an ICA of 247.0 +/- 32.0 ml/min, patients with 70 % stenosis a mean BVF of 225.3 +/- 32.2 ml/min (P = 0.4) without significant reduction, patients with 80 % stenosis a significant reduction of BVF to a mean flow of 184.0 +/- 53.8 ml/min (P < 0.005), patients with 90 % stenosis a reduction of the mean BVF in the stenosed ICA to 84.6 +/- 41.9 ml/min (P < 0.0005) and patients with stenoses > 95 % a mean BVF of only 26.0 +/- 4.0 ml/min (P < 0.0005). In patients with unilateral ICA stenosis greater than 81 %, a significant decrease of BVF in the stenosed ICA was documented.


CONCLUSIONS
Comparison of ultrasonographic grading of unilateral ICA stenosis and BVF determination in patients with ICA stenoses demonstrate a high correlation between increase in the stenosis and decrease in the ipsilateral blood flow beginning at 70 % stenosis. ICA stenoses greater than 80 % are significantly hemodynamically relevant.
Institut für Klinische Radiologie, Universitätsklinikum Mannheim, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg. wolfgang.neff@rad.ma.uni-heidelberg.de
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Neff
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Kilian
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Meairs
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Düber
D000368:Aged; D000369:Aged, 80 and over; D019412:Anatomy, Cross-Sectional / Q000379:methods*; D001783:Blood Flow Velocity; D001810:Blood Volume; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013223:Statistics as Topic; D018615:Ultrasonography, Doppler, Color / Q000379:methods*