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Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound

Atherosclerotic intracranial internal carotid artery stenosis (IICAS) is a leading cause of strokes. Due to the limitations of major cerebral imaging techniques, the early diagnosis of IICAS remains challenging. Clinical studies have revealed that arterial stenosis may have complicated effects on th...

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Autores principales: Zhang, Xiangdong, Wu, Dan, Li, Hongye, Fang, Yonghan, Xiong, Huahua, Li, Ye
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495671/
https://www.ncbi.nlm.nih.gov/pubmed/36134968
http://dx.doi.org/10.3390/bioengineering9090422
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author Zhang, Xiangdong
Wu, Dan
Li, Hongye
Fang, Yonghan
Xiong, Huahua
Li, Ye
author_facet Zhang, Xiangdong
Wu, Dan
Li, Hongye
Fang, Yonghan
Xiong, Huahua
Li, Ye
author_sort Zhang, Xiangdong
collection PubMed
description Atherosclerotic intracranial internal carotid artery stenosis (IICAS) is a leading cause of strokes. Due to the limitations of major cerebral imaging techniques, the early diagnosis of IICAS remains challenging. Clinical studies have revealed that arterial stenosis may have complicated effects on the blood flow’s velocity from a distance. Therefore, based on a patient-specific one-dimensional hemodynamic model, we quantitatively investigated the effects of IICAS on extracranial internal carotid artery (ICA) flow velocity waveforms to identify sensitive hemodynamic indices for IICAS diagnoses. Classical hemodynamic indices, including the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were calculated on the basis of simulations with and without IICAS. In addition, the first harmonic ratio (FHR), which is defined as the ratio between the first harmonic amplitude and the sum of the amplitudes of the 1st–20th order harmonics, was proposed to evaluate flow waveform patterns. To investigate the diagnostic performance of the indices, we included 52 patients with mild-to-moderate IICAS (<70%) in a case–control study and considered 24 patients without stenosis as controls. The simulation analyses revealed that the existence of IICAS dramatically increased the FHR and decreased the PSV and EDV in the same patient. Statistical analyses showed that the average PSV, EDV, and RI were lower in the stenosis group than in the control group; however, there were no significant differences (p > 0.05) between the two groups, except for the PSV of the right ICA (p = 0.011). The FHR was significantly higher in the stenosis group than in the control group (p < 0.001), with superior diagnostic performance. Taken together, the FHR is a promising index for the early diagnosis of IICAS using carotid Doppler ultrasound methods.
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spelling pubmed-94956712022-09-23 Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound Zhang, Xiangdong Wu, Dan Li, Hongye Fang, Yonghan Xiong, Huahua Li, Ye Bioengineering (Basel) Article Atherosclerotic intracranial internal carotid artery stenosis (IICAS) is a leading cause of strokes. Due to the limitations of major cerebral imaging techniques, the early diagnosis of IICAS remains challenging. Clinical studies have revealed that arterial stenosis may have complicated effects on the blood flow’s velocity from a distance. Therefore, based on a patient-specific one-dimensional hemodynamic model, we quantitatively investigated the effects of IICAS on extracranial internal carotid artery (ICA) flow velocity waveforms to identify sensitive hemodynamic indices for IICAS diagnoses. Classical hemodynamic indices, including the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were calculated on the basis of simulations with and without IICAS. In addition, the first harmonic ratio (FHR), which is defined as the ratio between the first harmonic amplitude and the sum of the amplitudes of the 1st–20th order harmonics, was proposed to evaluate flow waveform patterns. To investigate the diagnostic performance of the indices, we included 52 patients with mild-to-moderate IICAS (<70%) in a case–control study and considered 24 patients without stenosis as controls. The simulation analyses revealed that the existence of IICAS dramatically increased the FHR and decreased the PSV and EDV in the same patient. Statistical analyses showed that the average PSV, EDV, and RI were lower in the stenosis group than in the control group; however, there were no significant differences (p > 0.05) between the two groups, except for the PSV of the right ICA (p = 0.011). The FHR was significantly higher in the stenosis group than in the control group (p < 0.001), with superior diagnostic performance. Taken together, the FHR is a promising index for the early diagnosis of IICAS using carotid Doppler ultrasound methods. MDPI 2022-08-29 /pmc/articles/PMC9495671/ /pubmed/36134968 http://dx.doi.org/10.3390/bioengineering9090422 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zhang, Xiangdong
Wu, Dan
Li, Hongye
Fang, Yonghan
Xiong, Huahua
Li, Ye
Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound
title Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound
title_full Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound
title_fullStr Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound
title_full_unstemmed Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound
title_short Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound
title_sort early diagnosis of intracranial internal carotid artery stenosis using extracranial hemodynamic indices from carotid doppler ultrasound
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495671/
https://www.ncbi.nlm.nih.gov/pubmed/36134968
http://dx.doi.org/10.3390/bioengineering9090422
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