Abstract

Dr. Shadab Maqsood, Dr. Iqubal Hussain Dar, Dr. Yaqoob Hassan, Dr. Aabid Ashraf, Dr. Gh Hassan, Dr. Ramandeep Singh and Dr. Adil Sangeen

ABSTRACT

Objectives: The third leading cause of death in the world is Cerebral ischemic stroke. There is a close relationship between cerebral vascular disease and carotid artery stenosis. This study is done to evaluate carotid artery stenosis and plaque morphology by doppler ultrasonography. The main advantage of utrasonography of carotid arteries is patient comfort, lack of risk and accuracy in detecting carotid stenosis. Materials and Methods: A total of 150 patients were examined by duplex sonography in the time period of two years which included both indoor & outdoor patients visiting the ultrasound section of the department of Radiodiagnosis, Government Medical College Srinagar, with clinically Diagnosed cerebrovascular accident. Results: The highest incidence of stroke was found in the male population in the age group of 60–69 years. Of 150 patients, 12 patients showed significant stenosis (>60%). As the degree of stenosis increases, the ICA(internal carotid artery) PSV(peak systolic velocity) & EDV(End diastolic velocity) along with their respective ICA PSV/ CCA PSV ratio tends to increase in proportion to the stenosis, suggesting a positive correlation between them. In our study, 207 (69%) arteries had an IMT(Intima-media thickness) of less than or equal to 0.8mm and 93 (31%) had IMT above 0.8mm. The mean IMT both on right (0.796) and left side (0.818) were higher in males than that in females (0.732 & 0.751 respectively) for the age groups. In our study of 300 arteries examined, 225 plaques were found. It was observed that 83 out of 225 (36.9%) plaques were predominantly hypoechoic, while 65 (28.9%) were predominantly hyperechoic. The rest were calcified (77 out of 225 i.e. 34.2%). 10 out of 225 (4.5%) plaques showed surface irregularities, 4 of them were ulcerated (1.8%) and the remaining 211 (93.7%) were smooth in appearance. Out of the 10 irregular plaques, 6 (60%) were predominantly hypoechoic in appearance. 3 ulcerated plaques, were heterogeneously hyperechoic plaques. Out of the total 225 plaques, 116 (51.6%) were located in the region of the carotid bulb, 49 (21.8%) extending from bulb to ICA, 40 (17.8%) in ICA and 11 (4.9%) in the CCA. Conclusion: Color Doppler of carotid vessels is an excellent screening modality for the diagnosis of carotid artery occlusive disease. It also provides information regarding plaque characteristics and has the added advantage of being free of radiations and non-invasive.