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AJNR - American Journal of Neuroradiology

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Reappraisal of Flow Velocity Ratio in Common Carotid Artery to Predict Hemodynamic Change in Carotid Stenosis

Masahiro Kamouchi^a,c, Kazuhiro Kishikawa^a, Yasushi Okada^a, Tooru Inoue^b, Setsuro Ibayashi^c and Mitsuo Iida^c

^a Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, Kyushu University, Fukuoka, Japan
^b Department of Neurosurgery, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, Kyushu University, Fukuoka, Japan
^c Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

View larger version (27K): [in a new window]   FIG 1. Scatter plot of poststenotic flow versus the side-to-side ratio of EDVs. The abscissa indicates the poststenotic flow. Dotted line and shaded area indicate the EDV ratio at 1.0 and the range between 1.2 and 1.6, respectively. The line was drawn on the basis of the following equation: ED ratio = 2.16 x (poststenotic flow)–0.32; r = 0.63.

View larger version (21K): [in a new window]   FIG 2. Side-to-side ratios of EDV in the CCA were plotted according to the grade of the development of collateral pathways. Patients who had one or two collaterals and more than three collaterals were defined as moderate and extensive groups, respectively. Numbers in parentheses indicate the number of patients. *P < .0001 versus control group and moderate group. The EDV ratio exceeded 1.35 in all patients in the extensive group, although it was not below 1.5 in any collateral group.

View larger version (17K): [in a new window]   FIG 3. Receiver operator curves of the EDV ratio in the CCA for hemodynamic changes including severe reduction of poststenotic flow <3.4 mL/s (----), presence of intracranial collateral (------), and stenosis of diameter 70% calculated by the NASCET method (––).