Internal carotid artery stenosis (ICAS) is one of the most important factors leading to ischemic stroke due to various etiologies. The choice of clinical individualized treatment plan varies according to the severity of the lesion. With the continuous improvement of current diagnosis and treatment standards, higher demands are placed on the evaluation of ultrasonic imaging characteristics of ICAS. Ultrasound can not only identify the etiology of ICAS, grade the severity of stenosis, and evaluate cerebral blood perfusion, but also conduct long-term follow-up to evaluate treatment effectiveness and the control of risk factors. Accurate classification and evaluation of ICAS lesions by ultrasound imaging provide scientific and reliable objective information for clinical diagnosis and treatment, thereby assisting in the selection of clinical individualized treatment. Therefore, this article reviews the clinical application and progress of ultrasound in the evaluation of ICAS.

Li Jiashan, Yang Yujia, Quan Xuemeng. Application of ultrasound in the evaluation of internal carotid artery stenosis. Frontiers in Medical Science Research (2023) Vol. 5, Issue 10: 35-41. https://doi.org/10.25236/FMSR.2023.051006.

[1] Control CfD, Morbidity PJM, report mw. Prevalence of disabilities and associated health conditions among adults--United States, 1999. 2001;50(7):120-125.

[2] Rosamond W, Flegal K, Furie K, et al. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. 2008;117(4):e25-146.

[3] Varetto G, Gibello L, Sperti F, et al. Early Carotid Endarterectomy Provides a Better Neurological Outcome in Symptomatic Patients: A Single-Center Experience. 2017;45:62-68.

[4] Aboyans V, Ricco J-B, Bartelink M-LEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). 2018;39(9):763-816.

[5] Wangsheng L. The cause and effect of chronic internal carotid artery occlusion: Chinese expert consensus interpretation of chronic internal carotid artery occlusion recanalization treatment. Chinese Medical Information Herald. 2019;34(2):22-23.

[6] Hua Y, Zheng Y, Ling C, et al. Association of risk factors for atherosclerosis with carotid artery stenosis and ischemic stroke. Chinese Journal of Cerebrovascular Diseases. 2004;1(2):69-72.

[7] Steinvil A, Sadeh B, Arbel Y, et al. Prevalence and predictors of concomitant carotid and coronary artery atherosclerotic disease. 2011;57(7):779-783.

[8] Wu J, Wang Y, Wang A, et al. Association between non-high-density lipoprotein cholesterol levels and the prevalence of asymptomatic extracranial internal carotid artery stenosis in a Chinese community-based study. 2019;26(5):740-746.

[9] Xie Y. Clinical study of ankle-brachial index to evaluate the degree of cerebral artery stenosis in patients with ischemic stroke. Chinese Journal of senile cardio-cerebrovascular diseases. 2011;13(11):970-973.

[10] Genkel V, Kuznetsova A, Lebedev E, et al. Achilles Tendon Thickness Is an Independent Predictor of Carotid Atherosclerosis and Is Associated With a Carotid Plaque Burden. 2020;71(8):734-739.

[11] Spanos K, Tzorbatzoglou I, Lazari P, et al. Carotid artery plaque echomorphology and its association with histopathologic characteristics. 2018;68(6):1772-1780.

[12] Karapanayiotides T, Stroke GDJ. Fibrous cap thickness and stability of carotid atheromata. 2006;37(10):2451; author reply 2452.

[13] Polak JF, Alessi-Chinetti JM, Medicine FWKJJouimojotAIoUi. Doppler Velocity Estimates of Internal Carotid Artery Stenosis: Angle Correction Parallel to the Color Doppler Lumen Versus Parallel to the Artery Wall. 2019;38(12):3211-3218.

[14] Traenka C, Streifler J, Lyrer P, et al. Clinical Usefulness of Serial Duplex Ultrasound in Cervical Artery Dissection Patients. 2020;49(2):206-215.

[15] Chen L, Cao H, neurology MZJJ. The Trade-off Between the Bony Carotid Canal and Internal Carotid Artery. 2021;78(5):611-612.

[16] Collaborators NASCET, Barnett HJM, Taylor DW, et al. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. 1991;325(7):445-453.

[17] European Carotid Surgery Trialists’Collaborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST) %J Lancet (London, England). 1998;351(9113):1379-1387.

[18] Williams MA. Predicting the normal dimensions of the internal and external carotid arteries from the diameter of the common carotid. 1987;1(2):91-96.

[19] Murray CSG, Nahar T, Kalashyan H, et al. Ultrasound assessment of carotid arteries: Current concepts, methodologies, diagnostic criteria, and technological advancements. 2018;35(12):2079-2091.

[20] Staikov IN, Arnold M, Mattle HP, et al. Comparison of the ECST, CC, and NASCET grading methods and ultrasound for assessing carotid stenosis. European Carotid Surgery Trial. North American Symptomatic Carotid Endarterectomy Trial. 2000;247(9):681-686.

[21] Grant EG, Benson CB, Moneta GL, et al. Carotid artery stenosis: gray-scale and Doppler US diagnosis--Society of Radiologists in Ultrasound Consensus Conference. 2003;229(2):340-346.

[22] Hua Y, Liu B, Ling C, et al. Assessment of diagnostic accuracy of 50% -69% and 70%- 99% in carotid artery stenosis by ultrasonography. Chinese Journal of Cerebrovascular Diseases. 2006;3(5):211-218.

[23] Jia H, Liu X, Wu S, et al. CDFI three parameter criteria to evaluate the diagnostic value of ICAS. Medical review. 2015;21(6):1096-1098, 1093.

[24] Columbo JA, Zwolak RM, Arous EJ, et al. Variation in Ultrasound Diagnostic Thresholds for Carotid Stenosis in the United States. 2020;141(12):946-953.

[25] Li J, Liu G, Peng X. Discriminant analysis and principal component analysis of ultrasonic detection parameters of extracranial stenosis of internal carotid artery. Chinese Journal of Cerebrovascular Diseases. 2008;5(6):246-250.

[26] Bing H, Hua Y, Ling C, et al. Hemodynamics of ipsilateral common carotid artery in patients with moderate and severe internal carotid artery stenosis or occlusion. Chinese Journal of Cerebrovascular Diseases. 2008;5(12):536-540.

[27] Hariri N, Russell T, Kasper G, et al. Shear rate is a better marker of symptomatic ischemic cerebrovascular events than velocity or diameter in severe carotid artery stenosis. 2019;69(2):448-452.

[28] Larsson AC, physiology SRJC, imaging f. Diameter-based measurements of the degree of carotid artery stenosis using ultrasonography. 2021;41(2):217-220.

[29] Haiying G, Hengquan Z, Hui Y, et al. Evaluation of the diagnostic value of two dimensional gray scale flow imaging in the elderly patients with moderate to severe internal carotid artery stenosis. Zhejiang Medical Journal. 2014(21):1784-1786.

[30] Sabeti S, Schillinger M, Mlekusch W, et al. Quantification of internal carotid artery stenosis with duplex US: comparative analysis of different flow velocity criteria. 2004;232(2):431-439.

[31] Macharzina RR, Kocher S, Hoffmann F, et al. Accuracy of Carotid Artery Stenosis Quantification with 4-D-Supported 3-D Power-Doppler versus Color-Doppler and 2-D Blood Velocity-Based Duplex Ultrasonography. 2020;46(5):1082-1091.

[32] Shuqin G, Xianghong G, Yanling L, et al. Influence of extracranial stenosis of internal carotid artery on blood supply to the brain was analyzed by color Doppler ultrasonography combined with transcranial Doppler ultrasound. Chinese medical equipment. 2015(9):37-39,19.

[33] Ling C, Li K, Hua Y, et al. Ultrasound imaging evaluation of internal carotid artery stenosis and occlusion. Chinese medical imaging technology. 2002;18(7):647-650.

[34] Mackinnon AD, Aaslid R, Stroke HSMJ. Ambulatory transcranial Doppler cerebral embolic signal detection in symptomatic and asymptomatic carotid stenosis. 2005;36(8):1726-1730.

[35] Liu Y, Hua Y, Liu R, et al. Ultrasonographical Features Associated with Progression of Atherosclerosis in Patients with Moderate Internal Carotid Artery Stenosis. 2018;9(4):375-381.

[36] Tang Y, Wang M-Y, Wu T-T, et al. The role of carotid stenosis ultrasound scale in the prediction of ischemic stroke. 2020;41(5):1193-1199.

[37] Strosberg DS, Haurani MJ, Satiani B, et al. Common carotid artery end-diastolic velocity and acceleration time can predict degree of internal carotid artery stenosis. 2017;66(1):226-231.