Feasibility and Clinical Impact of Point-of-Care Carotid Artery Examinations by Experts using Hand-Held Ultrasound Devices in Patients with Ischemic Stroke or Transitory Ischemic Attack,Journal of Stroke & Cerebrovascular Diseases

当前位置： X-MOL 学术 › J. Stroke Cerebrovasc. Dis. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Feasibility and Clinical Impact of Point-of-Care Carotid Artery Examinations by Experts using Hand-Held Ultrasound Devices in Patients with Ischemic Stroke or Transitory Ischemic Attack
Journal of Stroke & Cerebrovascular Diseases ( IF 2.0 ) Pub Date : 2021-09-16 , DOI: 10.1016/j.jstrokecerebrovasdis.2021.106086
Lars Mølgaard Saxhaug _{1,

2} , Torbjørn Graven ₁ , Øystein Olsen ₃ , Jens Olaf Kleinau ₁ , Kyrre Skjetne ₁ , Hanne Ellekjær _{4,

5} , Håvard Dalen _{1,

2,

6}

Affiliation

Background and purpose

To evaluate the feasibility and clinical influence of carotid artery examinations in patients admitted with stroke or TIA with hand-held ultrasound by experts, to identify individuals not in need of further carotid artery diagnostics.

Materials and methods

Cardiologists experienced in carotid ultrasound examined 80 patients admitted to a stroke unit with suspected stroke or TIA with hand-held ultrasound devices (HUD). Grey scale and color Doppler images were stored using a GE Vscan with dual probe (phased array and linear transducer). High-end triplex ultrasound performed by a cardiologist, blinded to the details of the HUD study, was performed in all patients and used as reference. Computer tomography angiography was performed when clinically indicated.

Results

Stroke or TIA was diagnosed in 62 (78%) patients. Age was median (range) 72 (23–93) years. A significant stenosis (> 50% diameter reduction) was ruled out in 61 (76%) of patients by the HUD examinations. Sensitivity and specificity for diagnosing a significant stenosis was 92% and 93%, respectively. One of 12 significant stenoses was missed by HUD. All four patients in need of surgery were identified by the HUD examination. Sensitivity and specificity to identify a significant stenosis by HUD was 87% and 83%, respectively, compared to CT angiography.

Conclusion

HUD examinations of the carotid arteries by experts, using hand-held ultrasound devices, were feasible and may reduce the need for high-end diagnostic imaging of the carotid vessels in patients with stroke and TIA. Thus, HUD may improve diagnostic workflow in stroke units in the future.

中文翻译：

专家使用手持式超声设备对缺血性中风或短暂性脑缺血发作患者进行护理点颈动脉检查的可行性和临床影响

背景和目的

评估专家手持超声对卒中或 TIA 患者进行颈动脉检查的可行性和临床影响，以确定不需要进一步颈动脉诊断的个体。

材料和方法

在颈动脉超声方面经验丰富的心脏病专家使用手持式超声设备 (HUD) 检查了 80 名因疑似中风或 TIA 而入院的中风病房患者。使用带有双探头（相控阵和线性换能器）的 GE Vscan 存储灰度和彩色多普勒图像。由对 HUD 研究细节不知情的心脏病专家进行的高端三联超声在所有患者中进行并用作参考。有临床指征时进行计算机断层扫描血管造影。

结果

62 名 (78%) 患者被诊断出中风或 TIA。年龄中位数（范围）为 72 (23–93) 岁。通过 HUD 检查，61 名 (76%) 患者排除了显着狭窄（直径减小 > 50%）。诊断显着狭窄的敏感性和特异性分别为 92% 和 93%。HUD 漏掉了 12 个显着狭窄之一。所有需要手术的四名患者均通过 HUD 检查确定。与 CT 血管造影相比，HUD 识别显着狭窄的敏感性和特异性分别为 87% 和 83%。