Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Accuracy of the hemodynamic and geometric ultrasound measurement of carotid artery lesions compared with angiography

Authors: Gansukh A.1, Byambajav O.1, Gansukh T.1, Shumilina M.V.2, Shchanitsyn I.N.2, Yusifov A.S.2

Company:
1 “Oyun-Onosh” Center of the Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
2 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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DOI: https://doi.org/10.24022/1814-6910-2025-22-1-60-73

UDC: 616.133-073.43

Link: Clinical Physiology of Blood Circulaiton. 2025; 22 (1): 60-73

Quote as: Gansukh A., Byambajav O., Gansukh T., Shumilina M.V., Shchanitsyn I.N., Yusifov A.S. Accuracy of the hemodynamic and geometric ultrasound measurement of carotid artery lesions compared with angiography. Clinical Physiology of Circulation. 2025; 22 (1): 60–73 (in Russ.). DOI: 10.24022/1814-6910-2025-22-1-60-73

Received / Accepted:  03.02.2025 / 17.02.2025

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Abstract

The aim of the work was to evaluate the diagnostic accuracy of planimetric and hemodynamic assessment of the degree of carotid artery stenosis.

Material and methods. A single-center retrospective comparative study was conducted. The study included 602 patients (1179 arteries) with a full examination (ultrasound Doppler + angiography).

Results. According to ultrasound Doppler, ICA pathology was detected in 24.3%. Among the causes of stroke, atherosclerotic stenosis of the carotid arteries was detected in 17.3% of patients. Significant stenosis of the ICA (50–99%) was detected in 12.8% and occlusion in 4.3%. In univariate analysis, the probability of detecting an atherosclerotic plaque was significantly higher in patients with arterial hypertension (OR 2.9; IQR 2.1–4.1) and a history of stroke/TIA (OR 2.4; IQR 1.03–5.6). No associations were found with age, gender, diabetes, hypercholesterolemia, coronary artery disease, COPD, and smoking. A weak association was found between the degree of stenosis, plaque length of more than 2 cm, and the structure of atherosclerotic plaque (with increasing stenosis, hypo-/anechoic plaques were more often detected), arterial hypertension, and circumferential calcification. When comparing the hemodynamic assessment of the degree of ICA stenosis according to the SRU criteria with the CSA, only moderate agreement was obtained. With stenosis of 50–69%, the sensitivity of the hemodynamic assessment was lower than the planimetric one. In severe stenosis (70–95%), the sensitivity of planimetric and hemodynamic assessments was significantly higher, 97.7% and 86.0%, respectively. False-negative results of hemodynamic assessment were obtained in 13.9%.

Conclusion. Currently used fixed threshold values of PSS demonstrate high specificity for detecting severe stenosis, but can lead to an erroneous diagnosis and/or fail to detect small and/or gradual deviations from the norm. This suggests the need to adjust the hemodynamic criteria of SRU for moderate ICA stenoses and search for factors other than the degree of stenosis that affect the hemodynamic parameters of blood flow.

About Authors

  • Amarjargal Gansukh, Associate Professor, Researcher, Ultrasonic and Neuroradiologic Diagnostician; ORCID
  • Oyun Byambajav, Cand. Med. Sci., Professor, Ultrasonic and Neuroradiology Diagnostician; ORCID
  • Tserenchunt Gansukh, Cand. Med. Sci., Researcher, Professor of Radiology and Neuroradiology; ORCID
  • Margarita V. Shumilina, Dr. Med. Sci., Professor, Head of the Department of Ultrasound Studies of Cardiovascular and Organ Pathology, Ultrasonic Diagnostician; ORCID
  • Ivan N. Shchanitsyn, Cand. Med. Sci., Researcher, Cardiovascular Surgeon; ORCID
  • Ali S. Yusifov, Cand. Med. Sci., Researcher, Cardiologist; ORCID

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