頸動脈超音波duplex法による総頸動脈ED比(end-diastolic ratio)と頭部MRA(magnetic resonance angiography)所見の対比(神経内科学教室岩田誠教授退任記念特別号)

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The end-diastolic (ED) ratio of both common carotid arteries (CCAs) is one of the parameters on carotid artery ultrasonography. ED ratio is calculated by side-to-side ratio of end-diastolic flow velocities (EDFVs) bilaterally. When the difference of EDFVs of both CCAs is over 30% (i.e., ED ratio of CCA is over 1.4), it suggests that the distal stenosis of the internal carotid artery (ICA) or middle cerebral artery (MCA) on the lower side of EDFV. We examined 185 patients (Acute Stroke group: 78 patients; Screening group: 107 patients) who had a 1.4<ED ratio and could be with brain magnetic resonance angiography (MRA). The Screening group contained patients with hypertension, hyperlipidemia, and/or diabetes mellitus, and some patients had an old stroke episode. Stenosis/occlusion of carotid axis by MRA presents in 72 patients (38.9%) from both groups and 43 patients (55.1%) in the Acute Stroke group. This is a higher percentage than in just the Screening group (29 patients, 27.1%). But all 3.0<ED ratio patients have arterial stenosis/occlusion. In 1.4<ED ratio ≤3.0 Screening group patients, 44 patients present intima-media thickness (IMT) over 1.1mm, and 13 patients (29.5%) of those have arterial stenosis/occlusion. We divided the 72 patients who present with stenosis/occlusion into three groups by site (extra-cranial ICA, intra-cranial ICA, MCA). Extra-cranial ICA stenosis/occlusion had a higher ED ratio than other groups. In conclusion, the ED ratio of CCA is useful for the detection of distal stenosis, especially in acute stroke. It is also important to include atherosclerotic findings of B-mode.
2008-02-25

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