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Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography
BACKGROUND: Currently, no clear diagnostic indicator of vertebral artery hypoplasia (VAH) or intracranial stenosis exists in clinic. This study aims to study the feasibility of neck-brain integrated ultrasound for evaluating stenosis of the intracranial segment in the vertebral artery by comparing w...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576085/ https://www.ncbi.nlm.nih.gov/pubmed/33241004 http://dx.doi.org/10.21037/atm-20-5713 |
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author | Wang, Jianjun Ma, Qianfeng Yang, Zhenxing Ma, Liyuan |
author_facet | Wang, Jianjun Ma, Qianfeng Yang, Zhenxing Ma, Liyuan |
author_sort | Wang, Jianjun |
collection | PubMed |
description | BACKGROUND: Currently, no clear diagnostic indicator of vertebral artery hypoplasia (VAH) or intracranial stenosis exists in clinic. This study aims to study the feasibility of neck-brain integrated ultrasound for evaluating stenosis of the intracranial segment in the vertebral artery by comparing with those of computed tomography angiography (CTA) and digital subtraction angiography (DSA). METHODS: Clinical data of 138 patients who presented to our hospital with dizziness and headache as the main symptoms between April 2018 and June 2019 were retrospectively analyzed. Patients were divided into observation group and unilateral VAH group. The diagnosing accuracy of ultrasound, CTA, and DAS, the vertebral artery diameter (VAD), blood flow, end diastolic velocity (EDV), peak systolic velocity (PSV) values, resistance indexes (RIs), and difference of RI were compared between the two groups. The sensitivity, specificity and accuracy of ultrasound hemodynamic indicators in assessing stenosis of the intracranial segment of the vertebral artery were calculated. RESULTS: The accuracy rates of mild stenosis and non-stenosis with neck-brain integrated ultrasound were significantly different from those with CTA and DSA examination (P<0.05). The VAD, blood flow, EDV and PSV values of the affected side in the observation group were lower than those of the VAH side in the unilateral VAH group, while the RI and RI difference value were significantly higher than the unilateral VAH group (P<0.05). When the predicted boundary value was 2.084 mm (VAD), 56.41 mL/min (blood flow), 8.47 cm/s (EDV), 0.743 (RI), and 0.149 (difference of RI), the sensitivity and specificity were (86.43%, 49.45%), (88.67%, 47.42%), (80.47%, 68.71%), (82.71%, 84.66%), and (95.84%, 80.11%), respectively. CONCLUSIONS: Neck-brain integrated ultrasound is of great value as a noninvasive examination in the diagnosis of stenotic lesions of the internal cervical vertebral artery. VAD, EDV, blood flow, RI, and the difference in RI can be used as indicators to evaluate stenosis of the internal carotid segment of the vertebral artery and provide a reliable basis for the clinical diagnosis of posterior circulation ischemia. |
format | Online Article Text |
id | pubmed-7576085 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-75760852020-11-24 Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography Wang, Jianjun Ma, Qianfeng Yang, Zhenxing Ma, Liyuan Ann Transl Med Original Article BACKGROUND: Currently, no clear diagnostic indicator of vertebral artery hypoplasia (VAH) or intracranial stenosis exists in clinic. This study aims to study the feasibility of neck-brain integrated ultrasound for evaluating stenosis of the intracranial segment in the vertebral artery by comparing with those of computed tomography angiography (CTA) and digital subtraction angiography (DSA). METHODS: Clinical data of 138 patients who presented to our hospital with dizziness and headache as the main symptoms between April 2018 and June 2019 were retrospectively analyzed. Patients were divided into observation group and unilateral VAH group. The diagnosing accuracy of ultrasound, CTA, and DAS, the vertebral artery diameter (VAD), blood flow, end diastolic velocity (EDV), peak systolic velocity (PSV) values, resistance indexes (RIs), and difference of RI were compared between the two groups. The sensitivity, specificity and accuracy of ultrasound hemodynamic indicators in assessing stenosis of the intracranial segment of the vertebral artery were calculated. RESULTS: The accuracy rates of mild stenosis and non-stenosis with neck-brain integrated ultrasound were significantly different from those with CTA and DSA examination (P<0.05). The VAD, blood flow, EDV and PSV values of the affected side in the observation group were lower than those of the VAH side in the unilateral VAH group, while the RI and RI difference value were significantly higher than the unilateral VAH group (P<0.05). When the predicted boundary value was 2.084 mm (VAD), 56.41 mL/min (blood flow), 8.47 cm/s (EDV), 0.743 (RI), and 0.149 (difference of RI), the sensitivity and specificity were (86.43%, 49.45%), (88.67%, 47.42%), (80.47%, 68.71%), (82.71%, 84.66%), and (95.84%, 80.11%), respectively. CONCLUSIONS: Neck-brain integrated ultrasound is of great value as a noninvasive examination in the diagnosis of stenotic lesions of the internal cervical vertebral artery. VAD, EDV, blood flow, RI, and the difference in RI can be used as indicators to evaluate stenosis of the internal carotid segment of the vertebral artery and provide a reliable basis for the clinical diagnosis of posterior circulation ischemia. AME Publishing Company 2020-09 /pmc/articles/PMC7576085/ /pubmed/33241004 http://dx.doi.org/10.21037/atm-20-5713 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Wang, Jianjun Ma, Qianfeng Yang, Zhenxing Ma, Liyuan Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography |
title | Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography |
title_full | Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography |
title_fullStr | Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography |
title_full_unstemmed | Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography |
title_short | Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography |
title_sort | feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576085/ https://www.ncbi.nlm.nih.gov/pubmed/33241004 http://dx.doi.org/10.21037/atm-20-5713 |
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