Clinical Significance of Ultrasound-Based Hemodynamic Assessment of Extracranial Internal Carotid Artery and Posterior Cerebral Artery in Symptomatic and Angiographic Evolution of Moyamoya Disease: A Preliminary Study

Abstract

Objective: To investigate the hemodynamic changes using ultrasound according to digital subtraction angiography (DSA) findings and explore the association between ultrasound parameters and clinical symptoms of moyamoya disease (MMD).Methods: Hemodynamic parameters of extracranial internal carotid artery (EICA) and posterior cerebral artery (PCA) were evaluated by ultrasound. According to DSA findings, EICA parameters among Suzuki stages (stage I-II, III-IV, and V-VI), and PCA parameters among leptomeningeal system scores (score 0–2, 3–4, and 5–6) were compared, respectively. ROC analysis was performed based on the ultrasound parameters to distinguish stroke from non-stroke patients.Results: Forty patients with MMD were included in our study (16 men; median age, 37 years). The diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV) and flow volume (FV) of EICA decreased as the Suzuki stage advanced (D: P < 0.001; PSV: P < 0.001; EDV: P < 0.001; FV: P < 0.001). The PSV and EDV of PCA increased as the leptomeningeal system scores advanced (PSV: P < 0.001; EDV: P < 0.001). ROC analysis showed that the area under the curves (AUCs) based on the D and FV of EICA, the PSV and EDV of PCA and their combination were 0.688, 0.670, 0.727, 0.684, and 0.772, respectively, to distinguish stroke from non-stroke patients.Conclusions: Ultrasound parameters were related to Suzuki stages and leptomeningeal system scores. Ultrasound may be useful in predicting the occurrence of stroke in patients with MMD. Future prospective studies with large sample sizes and long-term follow-up are needed to confirm our preliminary findings.

Atherosclerosis from Newborn to Adult—Epidemiology, Pathological Aspects, and Risk Factors

“…The diagnostics of atherosclerotic cardiovascular diseases in children, teenagers, and young adults was limited to specialized centers. Due to more invasive and non-invasive advanced techniques, at present it is possible to detect the early formation of atherosclerotic plaques, and visualize the anatomical and mechanical abnormalities of the arteries through coronary angiography, optical coherence tomography, high-resolution B-mode ultrasonography, intravascular ultrasonography, Magnetic Resonance Imaging, or Scintigraphic techniques [132].…”

Transcranial color‐coded ultrasound for Moyamoya disease—A holistic diagnostic tool?

“…8 Zheng et al used TCCS to study the posterior cerebral artery along with carotid duplex studies of extracranial internal carotid artery in 55 patients with Moyamoya disease and reported a good association between these ultrasound parameters and previous ischemic or hemorrhagic stroke. 9 In this context, the study by Wang et al-"Transcranial color Doppler sonography as an alternative tool for evaluation of terminal internal carotid artery steno-occlusion in Moyamoya disease" makes an important contribution. 10 In 90 patients (171 hemispheres), with Moyamoya disease diagnosed using digital subtraction angiography, they performed TCCS studies using standard techniques to evaluate terminal internal carotid arteries (TICA).…”