Association Between Flow Acceleration in the Carotid Artery and Intracranial Aneurysms.

Abstract

OBJECTIVES:

In physiologic pulsatile flow, velocity acceleration is an independent factor determining wall shear stress experienced by the vascular endothelium. The purpose of this study was to evaluate Doppler indices of systolic velocity acceleration in extracranial cerebral vessels and the occurrence of intracranial aneurysms.

METHODS:

We reviewed medical records and 3.0-T brain magnetic resonance imaging with 3-dimensional time-of-flight magnetic resonance angiography of 1323 adults who underwent health checkups from June 2006 to November 2011, in whom 53 intracranial aneurysms were identified in 45 patients. Doppler ultrasound parameters of the carotid and vertebral arteries were analyzed in these 45 patients with aneurysms and compared with another 45 control participants matched for age and sex. We defined the maximum systolic acceleration (ACCmax ) as the maximum slope of the early phase of systolic acceleration on the Doppler waveform and the maximum acceleration index (AImax ) as the ratio of the ACCmax and peak systolic velocity.

RESULTS:

The Doppler analysis showed a significantly increased AImax and ACCmax in the common carotid artery (CCA), internal carotid artery, and vertebral artery in the aneurysm group. A cutoff 13.89 s-1 for the AImax of the CCA had sensitivity of 80% with a negative predictive value of 99% for intracranial aneurysms.

CONCLUSIONS:

This study suggests that the AImax of the CCA with a cutoff of 13.89 s-1 may be an alternative to 3-dimensional time-of-flight magnetic resonance angiography or computed tomographic angiography as a screening tool for intracranial aneurysms. Further prospective studies are needed to validate the diagnostic performance and cost-effectiveness of these indices for screening.

• Authors: Chun-Wei Chang, Yau-Yau Wai, Siew-Na Lim, Tony Wu
• Journal: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (J Ultrasound Med) Vol. 38 Issue 5 Pg. 1333-1340 (May 2019) ISSN: 1550-9613 [Electronic] England
• PMID: 30393875 (Publication Type: Journal Article)
• Copyright: © 2018 by the American Institute of Ultrasound in Medicine.

Topics

• Blood Flow Velocity (physiology)
• Carotid Arteries (diagnostic imaging, physiopathology)
• Female
• Humans
• Intracranial Aneurysm (diagnostic imaging, physiopathology)
• Male
• Middle Aged
• Prospective Studies
• Reproducibility of Results
• Ultrasonography, Doppler, Transcranial (methods)
• Vertebral Artery (diagnostic imaging, physiopathology)