GIÁ TRỊ CỦA SIÊU ÂM B-MODE TRONG CHẨN ĐOÁN HẸP ĐỘNG MẠCH CẢNH TRONG ĐOẠN NGOÀI SỌ

Abstract

Background: Stenosis of the extracranial internal carotid artery results in numerous serious consequences, particularly ischemic stroke. With the advancement of modern imaging diagnostic methods, the diagnosis of extracranial internal carotid artery stenosis is becoming more accurate, but B-mode ultrasound stands out as the method with many advantages. B-mode ultrasound is a method that is non-invasive, non-hemodynamic, and safe for early detection of extracranial internal carotid artery stenosis. Objectives: To describe the characteristics of extracranial internal carotid artery lesions and evaluate the value of B-mode ultrasound for the diagnosis of extracranial internal carotid artery stenosis in patients undergoing cerebral digital subtraction angiography (DSA). Materials and methods: A prospective transverse study involving 75 patients (total of 150 internal carotid arteries were examined) who had undergone extracranial carotid artery ultrasound and DSA at Can Tho University of Medicine and Pharmacy Hospital and Can Tho Central General Hospital from 3/2021 to 6/2023. Results: The primary cause of extracranial internal carotid artery stenosis was atherosclerosis, while thrombosis was the primary cause of occlusion. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for detection ≥50% of extracranial internal carotid atery stenosis were 97.6%, 96.3%, 91.1%, 99%, and 96.7%, respectively. The B-mode ultrasound (NASCET method) showed a high correlation (Spearman’s r_s = 0.692, 95% CI: 0.595 - 0.769, p<0.001) and very good agreement ( = 0.801, 95% CI: 0.707 - 0.895, p<0.001) with DSA results for extracranial internal carotid atery stenosis. Conclusion: B-mode ultrasound scans are simple, fast, safe, and highly accurate in detecting clinically significant internal carotid atery stenosis (with the degree of stenosis ≥50%).