Author/Editor		Tetičkovič, Erih; Matela, Jože
Title		Tridimenzionalna ultrasonografija v diagnostiki skoraj popolne zožitve in zapore notranje karotidne arterije
Translated title		Three-dimensional ultrasonography in diagnosing subtotal stenosis and occlusion of internal carotid artery
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 70, št. 7-8
Publication year		2001
Volume		str. 375-9
Language		slo
Abstract		Background. Ultrasonographic discrimination of subtotal stenosis from occlusion of the internal carotid artery (ACI) is frequently extremely complicated. Three-dimensional ultrasonography (3D US) is more reliable than color duplex ultrasonography, However, due to possible errors in the evaluation of subtotal stenosis and occlusion, 3D US should be complemented either by three-dimensional CT angiography (3D CTA) or classic angiography. Correct evaluation is extremely important for operative treatment of subtotal stenosis. Method. In 22 patients, 3D US revealed occlusion of the ACI and in 11 patients subtotal stenosis. In all cases, the ultrasonographic findings were compared with 3D CTA findings, in 8 cases also with those of conventional angiography. Results. It two patients, 3D US evaluated the blockage as an occlusion while 3D CTA as well as angiography showed it to be a subtotal stenosis. In one patient, lumen reduction was so marked that it was not revealed by 3D CTA but only by angiography. In another case, the filiform ACI stenosis was covered by a distinct acoustic shadow of calcinated plaque. When compared, the remaining findings showed no significant differences. Conclusions. it is our opinion that 3D US is a good screening diagnostic method for diagnosing subtotal stenosis and occlusion of the ACI. However, owing to possible errors, it should be combined with 3D CTA or classic angiography. A precise evaluation is very important as subtotal ACI stenosis requires early operative treatment while ACI occlusion only requires conservative treatment.
Summary		Izhodišča. Ultrazvočna razmejitev subtotalne stenoze od okluzije notranje karotidne arterije (ACI) povzroča pogosto velike težave. Zanesljivejša od barvne dvojne ultrasonografije je tridimenzionalna ultrasonografija (3D US). Zaradi možnih napak v oceni subtotalne stenoze in okluzije pa moramo 3D US dopolniti s tridimenzionalno CT angiografijo (3D CTA) ali s klasično angiografijo. Pravilna ocena je pomembna zaradi operativne terapije subtotalne stenoze. Metode. Pri 22 bolnikih smo s 3D US ugotovili okluzijo ACI, pri enajstih bolnikih pa subtotalno stenozo. Ultrazvočni izvid smo v vseh primerih primerjali s 3D CTA, v osmih primerih pa tudi s konvencionalno angiografijo. Rezultati. Pri dveh bolnikih smo s 3D US ocenili zaporo kot okluzijo, za katero pa sta 3D CTA in angiografija pokazali, da gre za subtotalno stenozo. Pri enem bolniku je bila redukcija žilne svetline tako izrazita, da je ni pokazala tudi 3D CTA, marveč šele angiografija. V drugem primeru pa je filiformno stenozo ACI prekrivala izrazita akustična senca kalciniranega plaka. Ostali izvidi pri primerjavi niso pokazali bistvenih razhajanj. Zaključki. Ocenjujemo, da je 3D US dobra presejevalna diagnostična metoda pri ugotavljanju subtotalne stenoze in okluzije ACI, vendar jo je treba zaradi možnih napak dopolniti s 3D CTA ali klasično angiografijo. Natančna ocena je zelo pomembna, saj je pri subtotalni stenozi ACI potrebna čimprejšnja operativna terapija, pri okluziji ACI pa samo konservativna terapija.
Descriptors		CAROTID STENOSIS CAROTID ARTERY, INTERNAL CEREBROVASCULAR DISORDERS ULTRASONOGRAPHY TOMOGRAPHY, X-RAY COMPUTED