Evaluation of distal turbulence intensity for the detection of both plaque ulceration and stenosis grade in the carotid bifurcation using clinical Doppler ultrasound.

Objectives: To determine the interrelationship of stenosis grade and ulceration with distal turbulence intensity (TI) in the carotid bifurcation measured using conventional clinical Doppler ultrasound (DUS) in vitro, in order to establish the feasibility of TI as a diagnostic parameter for plaque ul...

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Publicado en:European Radiology Vol. 23; no. 6; pp. 1720 - 1729
Autores principales: Wong, Emily Y, Nikolov, Hristo N, Rankin, Richard N, Holdsworth, David W, Poepping, Tamie L
Formato: research Journal Article
Publicado: Springer Nature Jun2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2013
      vid: 23
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      pub: Springer Nature
      place: New York, New York
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        2012121621
        10.1007/s00330-012-2741-6
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        atl: Evaluation of distal turbulence intensity for the detection of both plaque ulceration and stenosis grade in the carotid bifurcation using clinical Doppler ultrasound.
      aug:
        au:
          Wong, Emily Y
          Nikolov, Hristo N
          Rankin, Richard N
          Holdsworth, David W
          Poepping, Tamie L
        affil: Robarts Research Institute, University of Western Ontario, London, ON, Canada.
      sug:
        subj:
          Carotid Arteries Ultrasonography
          Carotid Stenosis Ultrasonography
          Ultrasonography, Doppler Methods
          Angiography Methods
          Anthropometry
          Blood Flow Velocity
          Carotid Arteries Pathology
          Carotid Stenosis Pathology
          Constriction, Pathologic
          Human
          Phantoms, Imaging
          Reproducibility of Results
          Risk Factors
          Time Factors
      ab: Objectives: To determine the interrelationship of stenosis grade and ulceration with distal turbulence intensity (TI) in the carotid bifurcation measured using conventional clinical Doppler ultrasound (DUS) in vitro, in order to establish the feasibility of TI as a diagnostic parameter for plaque ulceration.Methods: DUS TI was evaluated in a matched set of ulcerated and smooth-walled carotid bifurcation phantoms with various stenosis severities (30, 50, 60 and 70 %), where the ulcerated models incorporated a type 3 ulceration.Results: Post-stenotic TI was significantly elevated owing to ulceration in the mild and moderate stenoses (P < 0.001). TI increased with stenosis severity in both the ulcerated and non-ulcerated series, with a statistically significant effect of increasing stenosis severity (P < 0.001). Whereas TI in the mild and non-ulcerated moderate stenoses was less than 20.4 ± 1.3 cm s(-1), TI in the ulcerated moderate and severe models was higher than 25.6 ± 1.3 cm s(-1), indicating a potential diagnostic threshold.Conclusion: We report a two-curve relationship of stenosis grade and ulceration to distal TI measured using clinical DUS in vitro. Clinical DUS measurement of distal TI may be a diagnostic approach to detecting ulceration in the mild and moderately stenosed carotid artery.Key Points: • Patients with carotid artery plaque ulcerations are at higher risk of stroke. • Clinical Doppler ultrasound is routinely used to detect carotid artery stenosis. • Doppler ultrasound turbulence intensity can detect ulceration in realistic flow models. • Turbulence intensity also increases with stenosis severity independent of ulceration. • Doppler ultrasound should help in assessing both stenosis severity and ulceration.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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