Role of Carotid Ultrasonography Combined with Monocyte/HDL Ratio in Internal Carotid Artery Stenosis

Min-Qiang Bao; Yi-Nong Chen; Ji-Wei Jin; Dong-Dong Gui; Jie Wang; Shuang-Shuang Chen; Xiao-Ning Sheng; Zhang-Long Cheng; Yu Wang

doi:10.2174/0115734056289735240409083434

Role of Carotid Ultrasonography Combined with Monocyte/HDL Ratio in Internal Carotid Artery Stenosis

Curr Med Imaging. 2024 Apr 18. doi: 10.2174/0115734056289735240409083434. Online ahead of print.

Authors

Min-Qiang Bao^{1

2}, Yi-Nong Chen¹, Ji-Wei Jin³, Dong-Dong Gui⁴, Jie Wang¹, Shuang-Shuang Chen¹, Xiao-Ning Sheng¹, Zhang-Long Cheng⁵, Yu Wang²

Affiliations

¹ Department of Neurology, The Affiliated Xuan Cheng Hospital of WanNan Medical College, No. 51, Dabatang Road, Xuanzhou District, Xuancheng, 242000, China.
² Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei 230022, China.
³ Clinical laboratory, The Affiliated Xuan Cheng Hospital of WanNan Medical College, No. 51, Dabatang Road, Xuanzhou District, Xuancheng, 242000, China.
⁴ Department of Ultrasound Medicine, The Affiliated Xuan Cheng Hospital of WanNan Medical College, No. 51, Dabatang Road, Xuanzhou District, Xuancheng, 242000, China.
⁵ Department of Neurology, Guangde Traditional Chinese Medicine Hospital, Intersection of Guangli Road and Heping Road, Taocou Town, Guangde, 242200, China.

PMID: 38639287
DOI: 10.2174/0115734056289735240409083434

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.

Keywords: Carotid duplex ultrasonography (DUS); Digital subtraction angiography (DSA); High-risk patients.; Internal carotid artery (ICA) stenosis; MHR; PSV.