Evaluation of distal extracranial internal carotid artery by transoral carotid ultrasonography in patients with severe carotid stenosis.
Evaluation of distal extracranial internal carotid artery by transoral carotid ultrasonography in patients with severe carotid stenosis.
复制标题
经口颈动脉超声对重度颈动脉狭窄患者颅外段远端颈内动脉的评价
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
M. Iida
中科院分区：
文献类型：
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作者：
K. Kishikawa;M. Kamouchi;Y. Okada;Tooru Inoue;S. Ibayashi;M. Iida
背景和目的
传统的超声技术不允许颈内动脉（伊卡）的远端颈段的可视化。在一项对伊卡严重狭窄患者的研究中，我们进行了经口颈动脉超声检查（TOCU），以评估其对这段动脉成像的能力。
方法
该研究的参与者包括20名连续的患者，他们患有严重的颈动脉狭窄，并在1999年至2000年期间接受了颈动脉内膜切除术。在颈动脉内膜切除术前后前瞻性地进行TOCU、常规颈动脉超声检查和脑血管造影。
结果
在所有患者中，使用TOCU的B模式可以清楚地检测到伊卡远端部分，并且未观察到斑块。颈动脉内膜切除术后伊卡远端部分的直径（3.9 +/- 0.5 mm [平均值+/- SD]）与术前（3.5 +/- 0.8 mm）相比显著增加（P <0.01）。在7例患者中，术后伊卡远端直径增加> 10%。TOCU估计术后直径平均增加15.0 ± 23.0%，与脑血管造影结果（23.9 ± 33.7%）显著相关（P <0.01）。颈动脉超声显示横断面狭窄程度>95%的患者中，术后直径增加>10%的占71%，术前直径<3.0mm的患者中，术后直径增加>10%的占86%。
结论
TOCU提供了关于伊卡远端特征的额外信息，这些信息既不能通过常规颈动脉超声检查也不能通过血管造影术获得。
BACKGROUND AND PURPOSE
Conventional ultrasonography techniques do not allow visualization of the distal cervical segment of the internal carotid artery (ICA). In a study of patients with severe ICA stenosis, we performed transoral carotid ultrasonography (TOCU) to assess its ability to image this segment of the artery.
METHODS
The study participants consisted of 20 consecutive patients who had severe carotid stenosis and who underwent carotid endarterectomy between 1999 and 2000. TOCU, conventional carotid ultrasonography, and cerebral angiography were prospectively performed before and after carotid endarterectomy.
RESULTS
In all patients, the distal portion of the ICA could be clearly detected by B mode using TOCU and no plaque was observed. The diameter of the distal portion of the ICA significantly increased after carotid endarterectomy (3.9 +/- 0.5 mm [mean +/- SD]), compared with before (3.5 +/- 0.8 mm), when it was estimated by TOCU (P <.01). In seven patients, the postoperative diameter of the distal ICA increased >10%. The mean increase in the postoperative diameter was estimated to be 15.0 +/- 23.0% by TOCU, which significantly correlated with the findings (23.9 +/- 33.7%) based on cerebral angiography (P <.01). The diameter increased >10% postoperatively in 71% of the patients with the degree of cross-sectional stenosis >95% as shown by carotid ultrasonography and in 86% of the patients whose preoperative diameter was <3.0 mm.
CONCLUSION
TOCU provides additional information regarding the characteristics of the distal ICA that can be obtained neither by conventional carotid ultrasonography nor by angiography.