Key result
The combination of turbulence index and wall shear stress using high-frame-rate ultrasound vector flow imaging demonstrated high diagnostic performance for internal carotid artery stenosis (AUC 0.899).
Why the study?
This study explored the feasibility and efficacy of using high-frame-rate ultrasound vector flow imaging to quantitatively assess hemodynamics in atherosclerotic internal carotid artery stenosis using turbulence index and wall shear stress.
Does high-frame-rate ultrasound vector flow imaging (VFI) using turbulence index and wall shear stress accurately evaluate atherosclerotic internal carotid artery stenosis?
Observational (n=59)
Does high-frame-rate ultrasound vector flow imaging (VFI) using turbulence index and wall shear stress accurately evaluate atherosclerotic internal carotid artery stenosis?
Effect estimate: AUC 0.899
High-frame-rate ultrasound vector flow imaging using combined turbulence index and wall shear stress provides a promising noninvasive diagnostic tool for evaluating carotid artery stenosis.
Should not yet change ICAS workup; leaves open whether dual VFI parameters add incremental value in larger prospective studies.
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 (WSS mean ), and maximum WSS (WSS max ) 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). WSS max ([11.91 ± 6.73] vs. [4.43 ± 5.4] Pa, p < 0.001) and WSS mean ([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 WSS max /Tur or WSS mean /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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Hong et al. (2024) conducted an observational in Atherosclerotic internal carotid artery stenosis (ICAS) (n=59). High-frame-rate ultrasound vector flow imaging (VFI) dual-parameters vs. Proximal and distal artery segments was evaluated on Diagnostic performance in ICAS (AUC 0.899). The combination of turbulence index and wall shear stress using high-frame-rate ultrasound vector flow imaging demonstrated high diagnostic performance for internal carotid artery stenosis (AUC 0.899).
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