Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 47 min ago
Peer-reviewedCC BY 4.0Frontiers in Neurology

Territory-based ultrasound assessment for extracranial and vertebrobasilar arterial stenosis and carotid plaque vulnerability: a multicentre comparison with digital subtraction angiography and histopathology

  • Xiangyu Meng1
  • Hongxiang Fu2
  • Fengqin Shen3
  • Ying Wang4
  • Ting Lin4
  • Weina Jia5
  • Yuping Shen5
  • Yajun Tong1
  • Shicheng Yin2
  • Litao Sun1
5 affiliations
  1. 1Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College
  2. 2Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College
  3. 3Department of Ultrasound Medicine, Central Hospital of Haining
  4. 4Department of Ultrasound Medicine, Hangzhou First People's Hospital Affiliated to Westlake University
  5. 5Department of Ultrasonography, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province
Read full textDOICite

Abstract

Introduction: The diagnostic performance of ultrasound-based vascular assessment may vary by anatomical territory. We evaluated territory-specific ultrasound techniques for cervicocerebral arterial stenosis and compared cervical duplex ultrasound (CDU) with computed tomography angiography (CTA) for identifying carotid plaque vulnerability.

Methods: This retrospective multicentre study included 234 patients with ultrasound-based assessment, CTA and digital subtraction angiography (DSA) examinations conducted between January 2022 and January 2025, contributing 620 evaluable arterial segments. DSA was the reference standard for moderate-to-severe (>=50%) stenosis. In a separate analysis of 56 patients with matched carotid endarterectomy specimens, histopathology was the reference standard for plaque vulnerability.

Results: Across all arterial segments, territory-specific ultrasound assessment yielded a sensitivity of 79.56%, specificity of 81.79% and moderate agreement with DSA (kappa = 0.61). Diagnostic-performance point estimates were higher for extracranial segments assessed by CDU than for intracranial vertebrobasilar segments assessed by transcranial Doppler-based ultrasonography (sensitivity, 86.09% vs 62.50%; specificity, 85.20% vs 75.47%; kappa, 0.71 vs 0.38). For histologically confirmed carotid plaque vulnerability, CDU showed a sensitivity of 86.84%, specificity of 77.78% and accuracy of 83.93%; the corresponding CTA estimates were 31.58%, 100.00% and 53.57%.

Discussion: Ultrasound-based assessment showed complementary strengths across vascular territories. CDU demonstrated reliable performance for extracranial stenosis and higher sensitivity than routine CTA for vulnerable carotid plaques in this selected endarterectomy cohort, while transcranial Doppler-based ultrasonography provided additional haemodynamic information for intracranial vertebrobasilar disease despite lower diagnostic performance. These findings support territory-appropriate ultrasound as part of multimodal imaging rather than as a replacement for CTA or DSA.

Related

  1. Subarachnoid Hemorrhage Following Ischemic Stroke in Vertebrobasilar Dolichoectasia
    Masahiro Kashiura, Takashi Moriya
    Internal MedicinePeer-reviewedCC BY-NC-NDFull textNeurologyJ-STAGE
  2. Endovascular Recanalization of Non-Acute Vertebrobasilar Occlusion in Progressive Posterior Circulation Ischemia: A Case Report
    Gamaliel Wibowo Soetanto, Elvan Wiyarta
    Neurology internationalPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  3. Endovascular thrombectomy for mild vertebrobasilar artery occlusion: a hierarchical win-ratio analysis
    Y. Guo, X. Fan, Y. Xu +6
    medRxivPreprintAll rights reservedFull textNeurologymedRxiv
  4. Development and internal validation of a clinicopathological and CT radiomics based prediction model for extracranial distant metastasis after radical resection in early-stage non-small cell lung cancer
    Yimei Zhang, Biwei Liu, Qiyu Nian +4
    Journal of thoracic diseasePeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMC
  5. VB-ROI-focused segmentation-to-morphometry workflow for vertebrobasilar dolichoectasia assessment on MRA
    Jianheng Guan, Zhihua Liu, Hongkai Qiu +5
    Frontiers in neurologyPeer-reviewedCC BYFull textNeurologyEurope PMCCrossref

Cite

BibTeXRIS
BibTeX
@article{meng2026territorybased,
  title = {{Territory-based ultrasound assessment for extracranial and vertebrobasilar arterial stenosis and carotid plaque vulnerability: a multicentre comparison with digital subtraction angiography and histopathology}},
  author = {Xiangyu Meng and Hongxiang Fu and Fengqin Shen and Ying Wang and Ting Lin and Weina Jia and Yuping Shen and Yajun Tong and Shicheng Yin and Litao Sun},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = nov,
  doi = {10.3389/fneur.2026.1957579},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1957579/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Territory-based ultrasound assessment for extracranial and vertebrobasilar arterial stenosis and carotid plaque vulnerability: a multicentre comparison with digital subtraction angiography and histopathology
AU  - Xiangyu Meng
AU  - Hongxiang Fu
AU  - Fengqin Shen
AU  - Ying Wang
AU  - Ting Lin
AU  - Weina Jia
AU  - Yuping Shen
AU  - Yajun Tong
AU  - Shicheng Yin
AU  - Litao Sun
PY  - 2026
DA  - 2026/11/04
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1957579
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1957579/full
AB  - Introduction: The diagnostic performance of ultrasound-based vascular assessment may vary by anatomical territory. We evaluated territory-specific ultrasound techniques for cervicocerebral arterial stenosis and compared cervical duplex ultrasound (CDU) with computed tomography angiography (CTA) for identifying carotid plaque vulnerability.  Methods: This retrospective multicentre study included 234 patients with ultrasound-based assessment, CTA and digital subtraction angiography (DSA) examinations conducted between January 2022 and January 2025, contributing 620 evaluable arterial segments. DSA was the reference standard for moderate-to-severe (>=50%) stenosis. In a separate analysis of 56 patients with matched carotid endarterectomy specimens, histopathology was the reference standard for plaque vulnerability.  Results: Across all arterial segments, territory-specific ultrasound assessment yielded a sensitivity of 79.56%, specificity of 81.79% and moderate agreement with DSA (kappa = 0.61). Diagnostic-performance point estimates were higher for extracranial segments assessed by CDU than for intracranial vertebrobasilar segments assessed by transcranial Doppler-based ultrasonography (sensitivity, 86.09% vs 62.50%; specificity, 85.20% vs 75.47%; kappa, 0.71 vs 0.38). For histologically confirmed carotid plaque vulnerability, CDU showed a sensitivity of 86.84%, specificity of 77.78% and accuracy of 83.93%; the corresponding CTA estimates were 31.58%, 100.00% and 53.57%.  Discussion: Ultrasound-based assessment showed complementary strengths across vascular territories. CDU demonstrated reliable performance for extracranial stenosis and higher sensitivity than routine CTA for vulnerable carotid plaques in this selected endarterectomy cohort, while transcranial Doppler-based ultrasonography provided additional haemodynamic information for intracranial vertebrobasilar disease despite lower diagnostic performance. These findings support territory-appropriate ultrasound as part of multimodal imaging rather than as a replacement for CTA or DSA.
SN  - 1664-2295
ER  -