Evaluation of Carotid Stenosis in a High‐Stroke‐Risk Population by Hemodynamic Dual‐Parameters Based on Ultrasound Vector Flow Imaging

ABSTRACT Objective This study explored the feasibility of using high‐frame‐rate ultrasound vector flow imaging (VFI) to quantitatively assess hemodynamics in atherosclerotic internal carotid artery stenosis (ICAS) by evaluating dual‐parameters, turbulence index (Tur), and wall shear stress (WSS). Th...

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Main Authors: Shaofu Hong, Yinghui Dong, Wenjing Gao, Di Song, Mengmeng Liu, Weiyue Li, Yigang Du, Jinfeng Xu, Fajin Dong
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:Brain and Behavior
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Online Access:https://doi.org/10.1002/brb3.70150
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author Shaofu Hong
Yinghui Dong
Wenjing Gao
Di Song
Mengmeng Liu
Weiyue Li
Yigang Du
Jinfeng Xu
Fajin Dong
author_facet Shaofu Hong
Yinghui Dong
Wenjing Gao
Di Song
Mengmeng Liu
Weiyue Li
Yigang Du
Jinfeng Xu
Fajin Dong
author_sort Shaofu Hong
collection DOAJ
description ABSTRACT Objective This study explored the feasibility of using high‐frame‐rate ultrasound vector flow imaging (VFI) to quantitatively assess hemodynamics in atherosclerotic internal carotid artery stenosis (ICAS) by evaluating dual‐parameters, turbulence index (Tur), and wall shear stress (WSS). Their efficacy in evaluating carotid artery stenosis was also analyzed. Methods Fifty‐nine patients with ICAS were enrolled. B‐mode ultrasound and V Flow (a high‐frame‐rate VFI) were performed using the Resona R9 system. The stenosis rate was measured in grayscale mode, whereas the time‐averaged Tur index, the time‐averaged WSS (WSSmean), and maximum WSS (WSSmax) around stenosis were measured. The combined diagnostic efficacy of Tur inand WSS was also investigated. Results Compared to proximal to stenosis (Tur index, 2.88% ± 3.65%), highly disordered blood flow was observed in the stenotic (23.17% ± 15.52%, p < 0.001) and distal segment (25.86% ± 17.29%, p < 0.001). WSSmax ([11.91 ± 6.73] vs. [4.43 ± 5.4] Pa, p < 0.001) and WSSmean ([3.42 ± 2.67] vs. [0.86 ± 1.21] Pa, p < 0.001) were significantly bigger in stenotic than those in the distal segment. The differences in the ratio WSSmax/Tur or WSSmean/Tur among different segments around stenosis were statistically significant (p < 0.001). The combination of Tur index and WSS had the best diagnostic performance in ICAS (AUC, 0.899). Conclusion The application of Tur index and WSS for quantitative assessment of ICAS hemodynamic changes is feasible, with the combined evaluation of these two parameters providing incremental diagnostic value for carotid artery stenosis. VFI‐based dual quantitative parameters may offer promising noninvasive diagnostic tools for carotid artery stenosis in high‐stroke‐risk populations.
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spelling doaj-art-349f6b629cb549e491eadcc5b5068b4e2025-08-20T02:07:06ZengWileyBrain and Behavior2162-32792024-11-011411n/an/a10.1002/brb3.70150Evaluation of Carotid Stenosis in a High‐Stroke‐Risk Population by Hemodynamic Dual‐Parameters Based on Ultrasound Vector Flow ImagingShaofu Hong0Yinghui Dong1Wenjing Gao2Di Song3Mengmeng Liu4Weiyue Li5Yigang Du6Jinfeng Xu7Fajin Dong8Department of Ultrasound Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong ChinaDepartment of Ultrasound Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong ChinaDepartment of Ultrasound Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong ChinaDepartment of Ultrasound Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong ChinaDepartment of Ultrasound Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong ChinaDepartment of Radiology Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong ChinaUltrasound R&D Department Shenzhen Mindray Bio‐Medical Electronics Co., Ltd. Shenzhen Guangdong ChinaDepartment of Ultrasound Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong ChinaDepartment of Ultrasound Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong ChinaABSTRACT Objective This study explored the feasibility of using high‐frame‐rate ultrasound vector flow imaging (VFI) to quantitatively assess hemodynamics in atherosclerotic internal carotid artery stenosis (ICAS) by evaluating dual‐parameters, turbulence index (Tur), and wall shear stress (WSS). Their efficacy in evaluating carotid artery stenosis was also analyzed. Methods Fifty‐nine patients with ICAS were enrolled. B‐mode ultrasound and V Flow (a high‐frame‐rate VFI) were performed using the Resona R9 system. The stenosis rate was measured in grayscale mode, whereas the time‐averaged Tur index, the time‐averaged WSS (WSSmean), and maximum WSS (WSSmax) around stenosis were measured. The combined diagnostic efficacy of Tur inand WSS was also investigated. Results Compared to proximal to stenosis (Tur index, 2.88% ± 3.65%), highly disordered blood flow was observed in the stenotic (23.17% ± 15.52%, p < 0.001) and distal segment (25.86% ± 17.29%, p < 0.001). WSSmax ([11.91 ± 6.73] vs. [4.43 ± 5.4] Pa, p < 0.001) and WSSmean ([3.42 ± 2.67] vs. [0.86 ± 1.21] Pa, p < 0.001) were significantly bigger in stenotic than those in the distal segment. The differences in the ratio WSSmax/Tur or WSSmean/Tur among different segments around stenosis were statistically significant (p < 0.001). The combination of Tur index and WSS had the best diagnostic performance in ICAS (AUC, 0.899). Conclusion The application of Tur index and WSS for quantitative assessment of ICAS hemodynamic changes is feasible, with the combined evaluation of these two parameters providing incremental diagnostic value for carotid artery stenosis. VFI‐based dual quantitative parameters may offer promising noninvasive diagnostic tools for carotid artery stenosis in high‐stroke‐risk populations.https://doi.org/10.1002/brb3.70150carotid artery stenosisstroketurbulencevector flow imagingwall shear stress
spellingShingle Shaofu Hong
Yinghui Dong
Wenjing Gao
Di Song
Mengmeng Liu
Weiyue Li
Yigang Du
Jinfeng Xu
Fajin Dong
Evaluation of Carotid Stenosis in a High‐Stroke‐Risk Population by Hemodynamic Dual‐Parameters Based on Ultrasound Vector Flow Imaging
Brain and Behavior
carotid artery stenosis
stroke
turbulence
vector flow imaging
wall shear stress
title Evaluation of Carotid Stenosis in a High‐Stroke‐Risk Population by Hemodynamic Dual‐Parameters Based on Ultrasound Vector Flow Imaging
title_full Evaluation of Carotid Stenosis in a High‐Stroke‐Risk Population by Hemodynamic Dual‐Parameters Based on Ultrasound Vector Flow Imaging
title_fullStr Evaluation of Carotid Stenosis in a High‐Stroke‐Risk Population by Hemodynamic Dual‐Parameters Based on Ultrasound Vector Flow Imaging
title_full_unstemmed Evaluation of Carotid Stenosis in a High‐Stroke‐Risk Population by Hemodynamic Dual‐Parameters Based on Ultrasound Vector Flow Imaging
title_short Evaluation of Carotid Stenosis in a High‐Stroke‐Risk Population by Hemodynamic Dual‐Parameters Based on Ultrasound Vector Flow Imaging
title_sort evaluation of carotid stenosis in a high stroke risk population by hemodynamic dual parameters based on ultrasound vector flow imaging
topic carotid artery stenosis
stroke
turbulence
vector flow imaging
wall shear stress
url https://doi.org/10.1002/brb3.70150
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