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This study aimed to establish optimal criteria for evaluation of moderate (50%-69%) and severe (70%-99%) middle cerebral artery (MCA) stenosis with transcranial color-coded sonography (TCCS). A total of 375 cases provided 409 TCCS/digital subtraction angiography vessel pairs. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and mean flow velocity (MFV) of the MCA were measured. The stenotic/distal MFV ratios (SDRs) were calculated. With digital subtraction angiography as a reference, for 50%-69% MCA stenosis, the optimal combined criteria were PSV ≥180 cm/s (sensitivity 95.7%, specificity 64.9% and overall accuracy 69.7%); EDV ≥75 cm/s (90.0%, 66.4% and 68.7%); MFV ≥110 cm/s (95.7%, 64.0% and 69.4%); and SDR ≥2.5 (88.6%, 71.3% and 76.3%). Criteria for 70%-99% MCA stenosis were PSV ≥240 cm/s (93.5%, 89.9% and 85.5%); EDV ≥100 cm/s (96.8%, 89.0% and 87.3%); MFV≥160 cm/s (91.9%, 92.8% and 92.2%); and SDR ≥4 (87.1%, 92.2% and 91.4%). Parameters of the MCA detected by TCCS, especially SDR, may increase accuracy in diagnosis of 50%-69% and 70%-99% MCA stenosis. [ABSTRACT FROM AUTHOR]

The aim of the study described here was to establish ultrasound criteria for defining the severity of vertebral artery in-stent restenosis. A total of 197 patients with vertebral artery stents were enrolled in this study. Color Doppler ultrasonography was performed after stenting. Peak systolic velocity and end-diastolic velocity within the stent (PSV stent , EDV stent ) and at the intervertebral segments were recorded. The ratio of the PSV at the origin to that at the intervertebral segment was calculated. With digital subtraction angiography as the reference standard, the optimal cutoff values of hemodynamic parameters identifying 50%–69% and 70%–99% restenosis were determined by receiver operating characteristic analysis. The optimal cutoff values of hemodynamic parameters identifying 50%–69% restenosis were PSV stent ≥ 170 cm/s, EDV stent ≥45 cm/s and PSV ratio ≥2.7, and those for 70%–99% restenosis were PSV stent ≥220 cm/s, EDV stent ≥55 cm/s and PSV ratio ≥4.2. In conclusion, color Doppler ultrasonography is a reliable method for monitoring patients with avertebral artery stents. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the ultrasound-based carotid plaque characteristics associated with new cerebral ischemic lesions after carotid endarterectomy (CEA). Between January 2013 and December 2018, carotid duplex ultrasound was performed in 1061 patients who underwent CEA. Brain magnetic resonance diffusion-weighted imaging (DWI) was performed pre-operatively and within 30 d after CEA. New cerebral ischemic lesions on DWI were observed in 169 patients. The cutoff value gray-scale median (GSM) used to distinguish DWI-positive from DWI-negative patients was 30.5, with an area under the receiver operating characteristic curve of 0.837. A larger proportion of multiple DWI lesions were observed in the GSM ≤30.5 group (59.5% vs. 41.5%, p = 0.030). Univariate and multivariate analyses identified GSM ≤30.5, ulcerated carotid plaques and pre-operative ischemic symptoms as predictors of post-operative cerebral DWI lesions. Our results indicate that ultrasound-based carotid plaque characteristics help predict new cerebral ischemic lesions after CEA. [ABSTRACT FROM AUTHOR]