Title:Role of Carotid Ultrasonography Combined with Monocyte/HDL Ratio in
Internal Carotid Artery Stenosis
Volume: 20
Author(s): Min-qiang Bao, Yi-nong Chen, Ji-wei Jin, Dong-dong Gui, Jie Wang, Shuang-shuang Chen, Xiao-ning Sheng, Zhang-long Cheng and Yu Wang*
Affiliation:
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei 230022, China
Keywords:
MHR, PSV, Carotid duplex ultrasonography (DUS), Internal carotid artery (ICA) stenosis, Digital subtraction angiography (DSA), High-risk patients.
Abstract:
Background:
Carotid duplex ultrasonography (DUS) is the primary screening tool for carotid artery stenosis, but has low reliability. MHR, which is the ratio of
monocytes to high-density lipoprotein cholesterol (HDL-C), can be a marker for the degree and distribution of extracranial and intracranial
atherosclerotic stenosis.
Objective:
We determined the diagnostic value of DUS+MHR for internal carotid artery (ICA) stenosis.
Methods:
We divided 273 hospitalized patients into non-stenosis (<50%) and ICA stenosis (≥50%) groups based on Digital Subtraction Angiography (DSA).
We determined the peak systolic velocity (PSV) in the ICA on DUS, calculated the MHR, and investigated their relationship with ICA stenosis.
Results:
On DSA, 34.1% (93/273) patients had moderate-to-severe ICA stenosis. DUS and DSA showed low concordance for detecting ICA stenosis
(kappa = 0.390). With increasing age, the incidence of moderate-to-severe ICA stenosis increased. PSV, monocyte count, and MHR were
significantly greater in the stenosis group than in the non-stenosis group (P < 0.001), while the HDL-C level was significantly lower (P = 0.001).
PSV (OR: 1.020, 95% CI: 1.011–1.029, P < 0.001) and MHR (OR: 5.662, 95% CI: 1.945–16.482, P = 0.002) were independent risk factors for
ICA stenosis. The area under the receiver operating characteristic curve of PSV+MHR (0.819) was significantly higher than that of PSV or MHR
alone (77.42% sensitivity, P = 0.0207; 73.89% specificity, P = 0.0032).
Conclusion:
The combination of ICA PSV on DUS and MHR is better than PSV alone at identifying ICA stenosis and is well-suited to screen high-risk
patients.
