Can contrast-enhanced ultrasound with second-generation contrast agents replace computed tomography angiography for distinguishing between occlusion and pseudo-occlusion of the internal carotid artery?

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Citações na Scopus
20
Tipo de produção
article
Data de publicação
2015
Título da Revista
ISSN da Revista
Título do Volume
Editora
HOSPITAL CLINICAS, UNIV SAO PAULO
Citação
CLINICS, v.70, n.1, p.1-6, 2015
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. METHOD: Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients were examined again with Doppler ultrasound, as well as with contrast-enhanced ultrasound and computed tomography angiography. The diagnosis was based on the presence or absence of flow. RESULTS: Among the 78 cervical internal carotid arteries identified as occluded by Doppler ultrasound, occlusion was confirmed by computed tomography angiography in only 57 (73.1%), compared with 59 (77.5%) for which occlusion was confirmed by contrast-enhanced ultrasound (p>0.5 vs. computed tomography angiography). Comparing contrast-enhanced ultrasound with Doppler ultrasound, we found that the proportion of cervical internal carotid arteries classified as occluded was 24.4% higher when the latter was used (p<0.001). CONCLUSIONS: We conclude that, in making the differential diagnosis between occlusion and pseudo-occlusion of the cervical internal carotid artery, contrast-enhanced ultrasound with a second-generation contrast agent is significantly more effective than conventional Doppler ultrasound and is equally as effective as the gold standard (computed tomography angiography). Our findings suggest that contrast-enhanced ultrasound could replace computed tomography angiography in this regard.
Palavras-chave
Carotid Artery, Internal, Arterial Occlusive Diseases, Contrast Media, Microbubbles, Carotid Artery Diseases/Ultrasonography
Referências
  1. Ascher E, 2002, J VASC SURG, V35, P340, DOI 10.1067/mva.2002.120379
  2. Barnett SB, 2007, ULTRASOUND MED BIOL, V33, P173, DOI 10.1016/j.ultrasmedbio.2006.07.002
  3. Chen CJ, 2004, STROKE, V35, P83, DOI 10.1161/01.STR.0000106139.38566.B2
  4. Correas JM, 2001, EUR RADIOL, V11, P1316, DOI 10.1007/s003300100940
  5. Droste DW, 2000, ACTA NEUROL SCAND, V102, P1, DOI 10.1034/j.1600-0404.2000.102001001.x
  6. Droste DW, 1999, STROKE, V30, P2302
  7. El-Saden SM, 2001, RADIOLOGY, V221, P301, DOI 10.1148/radiol.2212001606
  8. Ferrer JME, 2000, J VASC SURG, V31, P736, DOI 10.1067/mva.2000.104599
  9. Frinking PJA, 2000, ULTRASOUND MED BIOL, V26, P965, DOI 10.1016/S0301-5629(00)00229-5
  10. Furst G, 1999, STROKE, V30, P1444
  11. Galiuto L, 2008, J AM COLL CARDIOL, V51, P552, DOI 10.1016/j.jacc.2007.09.051
  12. Hammond CJ, 2008, EUR J VASC ENDOVASC, V35, P405, DOI 10.1016/j.ejvs.2007.12.008
  13. HANKEY GJ, 1990, STROKE, V21, P209
  14. Hofstee DJ, 2000, CLIN NEUROL NEUROSUR, V102, P9, DOI 10.1016/S0303-8467(99)00081-5
  15. Hunt CH, 2009, AM J ROENTGENOL, V193, P1124, DOI 10.2214/AJR.09.2520
  16. Lewandowski C, 2001, ANN EMERG MED, V37, P202, DOI 10.1067/mem.2001.111573
  17. Lubezky N, 1998, EUR J VASC ENDOVASC, V16, P133, DOI 10.1016/S1078-5884(98)80154-8
  18. Main ML, 2008, AM J CARDIOL, V102, P1742, DOI 10.1016/j.amjcard.2008.08.019
  19. MANSOUR MA, 1995, AM J SURG, V170, P154
  20. Murphy KJ, 1996, AM J ROENTGENOL, V167, P847
  21. Ohm Christina, 2005, Vasc Endovascular Surg, V39, P237, DOI 10.1177/153857440503900304
  22. PORTER TR, 1994, J AM COLL CARDIOL, V23, P1440
  23. Puech-Leao P, 2010, J VASC INTERV RADIOL, V21, P465, DOI 10.1016/j.jvir.2009.11.018
  24. Remonda L, 2002, AM J NEURORADIOL, V23, P213
  25. Sardanelli F, 1999, J COMPUT ASSIST TOMO, V23, P208, DOI 10.1097/00004728-199903000-00008
  26. Sidhu PS, 2006, BRIT J RADIOL, V79, P44, DOI 10.1259/bjr/23954854
  27. Sitzer M, 1997, J NEUROIMAGING, V7, pS22
  28. Verlato F, 2000, J VASC SURG, V32, P293, DOI 10.1067/mva.2000.106953
  29. Willinsky RA, 2003, RADIOLOGY, V227, P522, DOI 10.1148/radiol.2272012071
  30. Youk JH, 2003, J ULTRAS MED, V22, P897
  31. Young B, 1996, STROKE, V27, P2216