Analysis of color doppler and hemodynamic parameters of severe intracranial vertebral artery stenosis with different Mori classifications / 中国脑血管病杂志

ABSTRACT

Objective To analyze and compare the intracranial and extracranial color doppler and hemodynamic parameters of severe intracranial vertebral artery stenosis (SIVAS) with different Mori classifications. Methods From January 2017 to June 2018,a total of 122 consecutive in-patients of symptomatic unilateral SI VAS were enrolled retrospectively in Xuanwu Hospital, Capital Medical University. Tliey were divided into Mori A,B,and C groups according to the criteria of Mori classifications by CT Angiography or DSA images. Characteristics of color doppler flow imaging (C D F I) in vertebral stenosis segment and blood flow parameters of spectrum doppler, including peak systolic velocity (PSV), end-diastolic velocity (E D V),mean flow velocity (M F V),resistance index (R I) and pulsatility index (PI) in both the stenosis segment and the proximal stenosis segment were detected and compared. Results Among 122 cases (122 branches),46 cases (46 branches) were Mori A type,55 cases (55 branches) were Mori B type and 21(21 branches) were Mori C type. There were no significant differences among different Mori types in ages,gender,lesion side,cerebrovascular disease risk factors such as hypertension,diabetes,hyperlipidemia and smoking and the incidence rate of posterior circulation infarction (all P > 0. 05). The average lesion length of Mori C group (16.0 ± 6.3 mm) was significant longer than that of Mori B group (7.0 ± 1.6 mm) and Mori A group (3.4 ± 0.8mm). The differences were statistically significant (F= 145. 297, P 0. 017). About 74. 1% (15) of Mori type C did not meet the hemodynamics criteria for severe stenosis. Conclusions Mori C type lesions of SIVAS differ from Mori A and B lesions in the local color imaging features, intracranial and extracranial hemodynamic parameters. Blood flow in Mori C type lesions can be manifested with low-velocity and high-resistance in extracranial segment and discontinuity in intracranial segment.