Transoral Carotid Ultrasonography as a Diagnostic Aid in Patients with Severe Carotid Stenosis
Transoral Carotid Ultrasonography as a Diagnostic Aid in Patients with Severe Carotid Stenosis
复制标题
经口颈动脉超声检查可辅助诊断严重颈动脉狭窄患者
作者：
K. Kishikawa;M. Kamouchi;Y. Okada;Tooru Inoue;S. Ibayashi;M. Iida
对颅外颈内动脉(ICA)远端的评价对于判断手术治疗高度颈动脉狭窄是否可取是必不可少的。当颈内动脉被长节段的器质性病变阻塞或严重狭窄时，颈动脉内膜剥脱术(CEA)被放弃。另一方面，对于仅位于颈内动脉近端限制性病变的严重颈动脉狭窄患者，CEA可能是有益的。传统的颈动脉超声有时不能提供足够的信息，因为钙化的斑块和/或分叉处的高位。新发展的经口颈动脉超声(TOCU)使我们能够观察远端颅外ICA并鉴别诊断。我们在此报告3例严重颈动脉狭窄，在这些病例中，TOCU提供了常规颈动脉超声和血管造影术所不能提供的必要信息。我们的结论是，在某些考虑CEA的情况下，TOCU提供了先决条件信息。
Evaluation of the distal portion of the extracranial internal carotid artery (ICA) is indispensable for the judgment of whether surgical treatment for high-grade carotid stenosis is preferable or not. When the ICA is occluded or severely stenosed by an organic lesion along the long segment, carotid endarterectomy (CEA) is abandoned. On the other hand, CEA may be beneficial in patients with severe carotid stenosis which is situated only in the restricted lesion of the proximal portion of the ICA. Conventional carotid ultrasonography sometimes cannot provide sufficient information due to calcified plaque and/or high position of bifurcation. Newly developed transoral carotid ultrasonography (TOCU) enables us to observe the distal extracranial ICA and distinguish the differential diagnosis. We herein report 3 cases of severe carotid stenosis in which TOCU provided the necessary information obtained neither by conventional carotid ultrasonography nor by angiogram. We concluded that TOCU provides prerequisite information in certain cases in which CEA is considered.