B-flow and B-flow with 3D and SRI postprocessing before intervention and monitoring after stenting of the internal carotid artery

Jung, E. M. and Kubale, R. and Clevert, D. -A. and Weskott, H. -P. and Prantl, L. and Herold, T. and Renz, M. and Rupp, N. and Tacke, J. (2007) B-flow and B-flow with 3D and SRI postprocessing before intervention and monitoring after stenting of the internal carotid artery. CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 36 (1). pp. 35-46. ISSN 1386-0291,

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Abstract

Objective: To investigate the extent to which B-flow and B-flow with 3D postprocessing and speckle reduction imaging (SRI) have advantages in appraising the morphology of a high-grade stenosis of the internal carotid artery (ICA) for preinterventional planning and for postinterventional ultrasonographic follow-up. Materials/methods: A comparative appraisal of flow with CCDS, power Doppler, B-flow and 3D B-Flow with SRI were carried out prospectively in 50 patients with > 70% stenosis according to NASCET criteria in contrast medium-enhanced MRA before and after the intervention. After stenting of the internal carotid artery (ICA), i.a. digital substraction angiography (DSA) served as an additional reference method. Results: In > 70% ICA stenosis, simultaneous imaging of the pre-stenotic, intra-stenotic and post-stenotic flow was attained with B-flow in 45/90 cases (90%), with power Doppler in 39/50 cases (78%) and with CCDS in only 31/50 cases (62%). After intervention, a complete detection of flow without overwriting or blooming artifacts was achieved in all 50 patients only by B-flow. The intrastenotic flow (p < 0.05) could be better demarcated against the lumen and the vessel wall before the intervention, whereas the flow within the stent could be very much better appraised after the intervention (p < 0.01) using 3D postprocessing of B-flow with additional SRI. Re-stenoses with hypoechoic vascular wall changes (3/50 patients) were detected at an early stage using B-flow. Conclusions: B-flow technique with SRI and 3D postprocessing can facilitate the intrastenotic detection of flow in > 70% ICA stenosis with fewer flow artifacts. After stenting, the perfused vascular lumen shows less flow artifacts compared with CCDS and power Doppler. In order to elucidate hemodynamic changes, additional Doppler examinations are still necessary.

Item Type: Article
Uncontrolled Keywords: DIGITAL-SUBTRACTION-ANGIOGRAPHY; MAGNETIC-RESONANCE ANGIOGRAPHY; DOPPLER SONOGRAPHY; CONTRAST MATERIAL; STENOSIS; ULTRASOUND; DUPLEX; QUANTIFICATION; PROTECTION; PLACEMENT;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Röntgendiagnostik
Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 11 Jan 2021 13:14
Last Modified: 11 Jan 2021 13:14
URI: https://pred.uni-regensburg.de/id/eprint/33379

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