Department of Neurology, The Lianyungang Hospital Affiliated to Xuzhou Medical University, 182 Tongguan North Road, Lianyungang, 222002, Jiangsu, China.
The Vascular Ultrasound Department, The Lianyungang Hospital Affiliated to Xuzhou Medical University, Lianyungang, Jiangsu, China.
Neurol Sci. 2020 May;41(5):1193-1199. doi: 10.1007/s10072-019-04204-8. Epub 2020 Jan 3.
To improve the accuracy of ultrasound techniques for the assessment of carotid stenosis, we designed a novel carotid artery stenosis ultrasound scale (CASUS), and evaluated its accuracy, reliability, and its value in predicting the occurrence of cardiovascular and cerebrovascular diseases in a prospective study.
A total of 750 patients with first-time ischemic stroke and hospitalized within 24 h were enrolled in the study. Using color Doppler ultrasound (CDUS), the degree of stenosis and blood flow (BF) in bilateral internal carotid arteries (ICA) and the V1-V3 segment of vertebral arteries (VA) was assessed. Cubic simulation curves for BF and global blood flow (GBF) over the stenosis score (SS), total stenosis score (TSS), and radiological imaging- total stenosis score (RI-TSS) were fitted and compared. The receiver operating characteristic (ROC) curves using TSS, RI-TSS, or GBF to predict various ischemic stroke endpoints were also analyzed and compared.
There was a linear relationship between SS and BF both ICA and VA (R2 were 0.734 and 0.783, respectively, both P < 0.05). Both TSS and RI-TSS with GBF showed an inverse "S" curve relationship (R2 was 0.839 and 0.843, all P < 0.05). The AUC values of TSS-based and RI-TSS-based predictions of each endpoint were all greater than 0.7 (all P < 0.05), but the differences of the AUC values between TSS, RI-TSS, and GBF were not statistically significant (all P > 0.05).
The novel CASUS can better reflect the level of cerebral reperfusion in patients with ischemic stroke and can better predict the occurrence of cardiovascular and cerebrovascular diseases.
为了提高颈动脉狭窄超声评估技术的准确性，我们设计了一种新的颈动脉狭窄超声评分（CASUS），并在一项前瞻性研究中评估了其准确性、可靠性及其预测心脑血管疾病发生的价值。
共纳入 750 例首次缺血性脑卒中且发病 24 h 内住院的患者。采用彩色多普勒超声（CDUS）评估双侧颈内动脉（ICA）和椎动脉（VA）V1-V3 段狭窄程度和血流（BF）。拟合 BF 与狭窄评分（SS）、总狭窄评分（TSS）和影像学总狭窄评分（RI-TSS）之间的立方模拟曲线，并进行比较。还分析和比较了使用 TSS、RI-TSS 或 GBF 预测各种缺血性脑卒中终点的受试者工作特征（ROC）曲线。
ICA 和 VA 的 SS 与 BF 之间呈线性关系（R2 分别为 0.734 和 0.783，均 P < 0.05）。TSS 和 RI-TSS 与 GBF 均呈反“S”曲线关系（R2 分别为 0.839 和 0.843，均 P < 0.05）。基于 TSS 和 RI-TSS 的各终点预测的 AUC 值均大于 0.7（均 P < 0.05），但 TSS、RI-TSS 和 GBF 的 AUC 值之间的差异无统计学意义（均 P > 0.05）。
新型 CASUS 能更好地反映缺血性脑卒中患者脑再灌注水平，能更好地预测心脑血管疾病的发生。
