Evaluation of the atherosclerostic characteristics in intracranial arteries, carotid arteries, and lower extremity arteries by ultrasonography in patients with type 2 diabetes

Objective To evaluate the characteristics of atherosclerosis and its occurrence profiles for intracranial arteries, carotid arteries, and lower extremity arteries in patients with type 2 diabetes mellitus by Color Doppler flow imaging(CDFI) and Transcranial Doppler (TCD ). Methods A total of 354 patients diagnosed as type 2 diabetes from September 2008 to April 2010 were recruited into this study. Hemodynamic characteristics in intracranial arteries were examined by TCD. The morphological features and hemodynamic characteristics of carotid arteries, lower extremity arteries were examined by CDFI. Intima-media thickness (IMT), plaque characteristics, vessel stenosis and occlusion were evaluated. The occurrences of atherosclerosis at different locations in the same subject were compared. Results The incidence of IMT increasing, plaque formation in carotid arteries was significantly higher than those in lower extremity arteries. However, the plaque characteristics at these two locations were similar, i.e. most plaques were multiple, regular shapes with calcified echoes. The incidence of vascular stenosis in the intracranial arteries was much higher than that in carotid arteries and lower extremity arteries. And there was no difference in the incidence between the latter two locations. The characteristics of intracranial arterial stenosis were multiple vessels involved and most of them were mild stenosis. The incidence of stenosis in anterior circulation was higher than that in posterior circulation. The middle cerebral artery was the most serious vulnerable vessel. Most of the plaques in lower arterial extremity was located at common femoral artery, while stenosis and occlusion were mainly observed in the distal arteries. Conclusion Combination of CDFI and TCD can evaluate atherosclerosis at different locations in patients with type 2 diabetes, which have clinic significance to predict and prevent the occurrence of vascular complications in cerebrovasculature and lower extremity.