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Doctoral Thesis
DOI
10.11606/T.5.2010.tde-24112010-181156
Document
Author
Full name
Carlos Augusto Ventura Pinto
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2010
Supervisor
Committee
Chammas, Maria Cristina (President)
Amaro Júnior, Edson
Kodaira, Sergio Keidi
Macedo, Tulio Augusto Alves
Shigueoka, David Carlos
Title in Portuguese
Contraste por microbolhas em ultrassonografia no diagnóstico diferencial entre oclusão e pseudo-oclusão da artéria carótida interna: correlação com a  angiotomografia
Keywords in Portuguese
Artéria carótida interna
Estenose das carótidas
Microbolhas
Tomografia
Ultrassonografia
Abstract in Portuguese
Objetivo: Avaliar a eficácia da ultrassonografia com contraste (US com contraste) de segunda geração no diagnóstico diferencial entre oclusão e pseudo-oclusão de artéria carótida interna cervical (ACI) comparativamente à ultrassonografia com Doppler (US Doppler) utilizando a angiotomografia computadorizada (angio-TC) como padrão-ouro. Materiais e Métodos: Estudo prospectivo realizado entre junho de 2006 e junho de 2008 com 72 pacientes sintomáticos (57; 15) e 78 com ACIs aparentemente ocluídas pela US Doppler. Esses pacientes foram submetidos inicialmente à US Doppler e, em seguida, à US com contraste. Todos os pacientes realizaram posteriormente a angio-TC, utilizada como padrão-ouro. A correlação entre os métodos foi feita através de estudo duplo cego. Resultados: A sensibilidade, a especificidade e a acurácia da US com contraste foram respectivamente de 100%; 90,5% e 97,4%. Quando comparada à angio-TC, a quantidade de falsas oclusões pela US Doppler foi de 26,9% (21/78), (p < 0,001), enquanto que pela US com contraste foi de 2,6% (2/78) (p = 0,500). A US com contraste obteve melhor resultado que a US Doppler, com diferença estatisticamente significante (p < 0,001). Conclusão: A US com contraste é tão eficaz quanto a angio-TC e superior à US Doppler no diagnóstico diferencial entre oclusão e pseudo-oclusão da ACI
Title in English
Ultrasound microbubble contrast for distinguishing the diagnosis of cervical internal carotid artery occlusion from the one of pseudo-occlusion utilizing computerized angiotomography as the gold standard
Keywords in English
Carotid stenosis
Internal carotid artery
Microbubbles
Tomography
Ultrasound
Abstract in English
Purpose: Evaluate the efficacy of second-generation contrast ultrasound (CEUS) for distinguishing the diagnosis of cervical internal carotid artery (ICA) occlusion from the one of pseudo-occlusion when compared with Doppler Ultrasound (DUS) utilizing computerized angiotomography (CTA) as the gold standard. Material and Methods: A prospective study was performed between June 2006 and June 2008 with 72 symptomatic patients (57 males; 15 females) and 78 ICAs apparently occluded by DUS. These patients were initially subjected to DUS and then to CEUS. All patients went through CTA later on, used as the gold standard. Correlation between the methods was made by means of a double-blind study. Results: The sensitivity, specificity and accuracy of CEUS were taken as 100%, 90.5% and 97.4% respectively. When compared with CTA the amount of false occlusions by DUS was 26.9% (21/78), (p < 0.001) whereas by CEUS 2.6% (2/78) (p = 0.500) was seen. Far better results were obtained with CEUS than with DUS with a significant discrepancy (p < 0.001). Conclusion: CEUS shows to be as effective as CTA but better than DUS for distinguishing the diagnosis of ICA occlusion from the one of pseudo-occlusion
 
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Publishing Date
2010-11-26
 
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