American Journal of Neuroradiology, Vol 18, Issue 8 1447-1452, Copyright © 1997 by American Society of Neuroradiology
ARTICLES |
Duplex carotid sonography in distinguishing acute unilateral atherothrombotic from cardioembolic carotid artery occlusion
K Kimura, K Yonemura, T Terasaki, Y Hashimoto and M Uchino
Department of Cerebrovascular Disease, Kumamoto City Hospital, Japan.
PURPOSE: To distinguish between acute complete unilateral cardioembolic and atherothrombotic internal carotid artery (ICA) occlusion by using duplex carotid sonography. METHODS: We studied 11 patients with cardioembolic ICA occlusion (CE group), 32 patients with atherothrombotic ICA occlusion (AT group), and 25 patients with normal angiographic findings (control group). We obtained B-mode scans and measured the end-diastolic flow velocity (EDV) in both common carotid arteries within 3 days of the onset of symptoms. Side-to-side ratios of EDV (ED ratio) were calculated by dividing the flow velocity on the unaffected side by that on the affected side. RESULTS: In the AT group, the proximal ICA was full, with a large area of heterogeneous and partially calcified plaque, and the EDV (10.9 +/- 6.1 cm/s) was significantly lower than that in the control group (20.3 +/- 6.0 cm/s). The ED ratio was greater than 1.4 in all but one patient. In three patients in the CE group, B-mode scans showed a mobile, echogenic intravascular structure in the proximal ICA. The EDV (1.8 +/- 3.4 cm/s) was significantly lower than that in the control and AT groups. The ED ratio was greater than 1.4 in all cases. CONCLUSION: We conclude that B- mode scans and the EDV in the common carotid artery can help to distinguish between acute cardioembolic and atherothrombotic ICA occlusion.
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