Imaging Diagnosis of Ischemic Cerebrovascular Disease due to Carotid Stenosis──A Report of 15 Cases

Objective To evaluate non invasive imaging techniques in the diagnosis of carotid stenosis and to study the relationship between the carotid stenosis and cerebral infarction. Materials and Methods Doppler ultrasound (DUS), MR angiography (MRA) were performed for 30 carotid arteries of 15 patients, while CT and MRI scanning of the brain were done simultaneously. Additional CT angiography (CTA) was made in 5 patients, the results in 4 of which were compared with that of DSA. Carotid endarterectomy was carried out in 6 patients with severe stenosis. Results Of 30 carotid arteries, mild stenosis was seen in 8, moderate in 6, severe in 8, obstructed in 2 and normal in 2. In cases with severe carotid stenosis, more infarction lesions were demonstrated on the ipsilateral cerebral hemisphere. Large infarction of the middle cerebral artery distribution was seen in 2 cases with carotid occlusion. Atheromatous plaques were well delineated on CTA.Conclusion A strong link exists between the carotid stenosis and cerebral infarction. A combination of DUS, MRA and CTA is of great help in the screening, diagnosing and monitoring of carotid stenosis.