The combined value of carotid ultrasound flow parameters and transcranial color doppler ultrasound in the evaluation of compensatory cerebral collateral circulation in patients with carotid artery stenosis

NIE Jiaqiu; ZHOU Li; GAO Fei; YANG Xiangfeng; QU Shanshan; KOU Guangling; GUO Liping; LIU Ping

doi:10.20258/j.cnki.1006-9011.2025.10.006

Abstract：Objective To explore the value of carotid ultrasound hemodynamic parameters combined with transcranial color-coded Doppler(TCCD)in evaluating cerebral collateral circulation opening in patients with carotid artery stenosis(CAS).Methods A total of 165 patients with unilateral CAS were selected.They underwent carotid ultrasound examination to record the peak systolic velocity(PSV),end-diastolic velocity(EDV),and pulsatility index(PI).TCCD examination was performed to assess the opening of collateral circulation via the anterior communicating artery(ACoA),posterior communicating artery(PCoA),and ophthalmic artery(OA).Using digital subtraction angiography(DSA)findings as the gold standard,the consis-tency between TCCD and DSA in diagnosing cerebral collateral circulation opening was analyzed.Carotid ultrasound hemody-namic parameters were compared among patients with different collateral circulation opening statuses.The receiver operating char-acteristic(ROC)curve was used to analyze the diagnostic value of carotid ultrasound hemodynamic parameters combined with TCCD for cerebral collateral circulation opening.Results The diagnosis of cerebral collateral circulation opening by TCCD showed high consistency with that by DSA(Kappa=0.977,P<0.01).There were statistically significant differences in carotid ul-trasound hemodynamic parameters among patients with different collateral circulation opening statuses.The PSV and EDV in pa-tients with ACoA,PCoA,OA,or ACoA combined with PCoA opening were higher than those in patients without collateral circula-tion opening,while,the PI was lower(P<0.05).ROC curve analysis showed that the combination of carotid ultrasound hemody-namic parameters and TCCD for diagnosing cerebral collateral circulation opening in CAS patients had an area under the curve(AUC)of 0.999,a sensitivity of 96.85%,and a specificity of 100%.Conclusion The patterns of cerebral collateral circulation opening in CAS patients are closely related to carotid ultrasound hemodynamic parameters.The combination of carotid ultrasound hemodynamic parameters and TCCD is helpful for the early diagnosis of cerebral collateral compensation in CAS patients.