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Japanese

ULTRASONIC DOPPLER SONOGRAPHY FOR INTERNAL CAROTID OBSTRUCTIVE DISEASE AND ITS LIMITATION Hirao Kaneda 1 , Tadayoshi Irino 1 , Eiji Kadota 1 , Mamoru Taneda 1 , Ziro Kaneko 2 1Division of cerebrovascular diseases, Hanwa Hospital 2Kansai Rosai Hospita pp.425-432
Published Date 1980/4/1
DOI https://doi.org/10.11477/mf.1406204575
  • Abstract
  • Look Inside

A lot of reports suggested that obstructive lesions in the internal carotid artery (ICA) could be di-agnosed noninvasively using ultrasonic Doppler technique. However, diagnostic reliability for these diseases as well as the technical procedure in using ultrasonic Doppler flowmeter did vary among the authors. In the present study, diagnostic reliability of Doppler ultrasound was examined on the diseases of complete occlusion, high grade stenosis, low grade stenosis of the ICA and stem occlusion of the middle cerebral artery.

Blood flows in the supratrochlear, ophthalmic and internal carotid arteries were measured by the directional ultrasonic Doppler flowmeter of dual filter type. Signals of the blood flow were analysed by a sound spectrograph to produce a sonogram.

Clinical subjects consisted of 50 occlusions, 18 stenoses more than 50%, 32 stenoses less than 50% of the ICA, 26 stem occlusions of the middle cere-bral artery and 80 ICAs without obstructive lesions. All of them were diagnosed angiographically.

Ultrasonic Doppler findings of blood flows in the supratrochlear and ophthalmic arteries were classified into five groups; 1) normal flow type with normal response, 2) no flow signal type, 3) mixed flow type, 4) reversed flow type, 5) physio-logical flow type with abnormal response.

Blood flows in the ICA was divided into two groups; continuous flow type and discontinuous flow type according to a critical live of S= 3.625d-2.5 (S and d; maximum blood flow velocity at systolic and diastolic).

Finally, blood flow findings of both internal carotid and ophthalmic arterial territory in a patient were combinedly analysed and classified into normal, probably abnormal or abnormal Doppler finding.

The diagnostic reliability of the Doppler ultra-sound was good for the occlusions and high grade stenoses of the ICA. Ultrasonic Doppler finding was abnormal in 92% and probably abnormal inthe other 8% of the 50 complete occlusions. It was abnormal in 39%, probably abnormal in 17% and normal in 44% of the 18 high grade stenoses, but all of 6 cases with more than 75% stenosis had abnormal Doppler findings.

Diagnostic reliability was not satisfactory for the low grade stenoses of the ICA and the stem occlusion of the middle cerebral artery. The Doppler finding was abnormal only in 3%, probably abnormal in 19% and normal in 78% of the low grade stenoses. It was probably abnormal in 35% of the stem occlusion of the middle cerebral artery.

These diagnostic levels might be a limitation of the conventional ultrasonic flowmeters of directional continuous wave Doppler ultrasound. Newly developing ultrasonic instruments, such as B-mode or Doppler imaging of arteries, shall improve di-agnostic reliability for stenotic lesions of the ICA.


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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