| Objective:The ultrafast pulse wave velocity(UFPWV)technique was used to evaluate carotid artery stiffness in patients with Moyamoya disease(MMD)and to provide diagnosis and treatment information for early clinical intervention.Methods:This study was divided into two parts.In the first part,in order to ensure the accuracy and repeatability of UFPWV technique,15 healthy physical examination volunteers were selected from our hospital during the study period to undergo routine carotid artery ultrasound examination to rule out the presence of carotid artery plaque or abnormal carotid artery running,and then underwent ultrasonic pulse wave(PWV)examination to determine the elastic function of their carotid arteries.The second part is to study the evaluation value of UFPWV technique on carotid vascular elastic function in patients with MMD.Sixty-four patients with MMD(age 51.92±7.92 years old,46.88% male)in neurosurgery outpatients or inpatients of our hospital were collected,and 64 healthy subjects(age 51.61±8.54,48.43% male)matching age and sex were collected as control group.General data of the subjects were collected,including age,gender,fasting blood glucose,blood pressure and blood lipid.Conventional carotid artery standard examination images of all subjects were collected,and conventional measurement parameters such as the end-systolic diameter of the common carotid artery,Intima-media thickness(IMT),carotid peak systolic blood flow velocity(PSV),carotid end-diastolic blood flow velocity(EDV),carotid artery resistance index(RI)were obtained.UFPWV technique was used to obtain parameters such as the PWV at the beginning of systole(PWVBS)and the PWV at the end of systole(PWVES).The differences of conventional carotid artery measurement parameters and PWV parameters were compared between MMD group and healthy control group.Correlation analysis was conducted between PWVBS,PWVES and conventional carotid artery measurement parameters.The optimal cutoff values of PWVBS and PWVES in diagnosing MMD were established by drawing receiver operation characteristic curve(ROC).Results:1.Consistency test and repeatability test: The Bland Altman scatter plot showed that all test results were within the 95% confidence interval;ICC values of intragroup correlation coefficients were all > 0.75.2.Comparison of general data: There was no statistical significance in gender,age,fasting blood glucose,blood lipid,blood pressure and other general clinical data between MMD group and control group(P > 0.05).3.Comparison of conventional carotid ultrasound parameters and PWV parameters: there was no statistical significance in the values of left and right endsystolic diameter of the common carotid artery,IMT,PSV,EDV,RI,PWVBS and PWVES of all subjects(P > 0.05).Therefore,average values of the above parameters were combined for follow-up study and analysis.There was no significant difference in the end-systolic diameter of the common carotid artery,IMT,PSV,EDV,RI and other conventional ultrasound parameters between MMD group and control group(P > 0.05).Compared with the healthy control group,the carotid PWVBS and PWVES values in MMD group were significantly increased,and the difference was statistically significant(P < 0.05).4.Correlation analysis: PWVBS was positively correlated with IMT(r=0.576,P < 0.001),PWVES was positively correlated with IMT(r= 0.627,P < 0.001),and there was no significant correlation between the end-systolic diameter of the common carotid artery,PSV,EDV,RI and PWVBS,PWVES.(P > 0.05).5.Value of PWV parameters in the diagnosis of MMD: The area under ROC curve(AUC)of PWVBS and PWVES in the diagnosis of MMD were 0.889(95%confidence interval 0.836,0.942)and 0.854(95% confidence interval 0.785,0.922),respectively.When PWVBE value was 6.67 m/s,the sensitivity and specificity of MMD were 79.7% and 79.7%.When PWVES value was 8.38 m/s,the sensitivity and specificity of MMD were 78.1% and 89.1%.Conclusion:1.The UFPWV technique has good consistency and repeatability,which can provide an important reference for clinical evaluation of carotid artery elasticity.2.Compared with healthy people,the carotid PWVBS and PWVES values were increased in patients with MMD,suggesting increased carotid artery stiffness in patients with MMD.3.PWVBS and PWVES were positively correlated with IMT,but the increases of PWVBS and PWVES in MMD patients were earlier than the thickening of IMT.4.The elevation of carotid PWVBS or PWVES values for MMD is helpful to provide a basis for clinical observation or further management. |
