Ultrasound parameters associated with stroke in patients with moyamoya disease: a logistic regression analysis

Chin Neurosurg J. 2022 Oct 11;8(1):32. doi: 10.1186/s41016-022-00300-5.

Abstract

Background: Moyamoya disease can lead to stroke with devastating consequences, it is necessary to find a non-invasive and effective approach to identify the occurrence of stroke. In this study, we aim to analyze the association between ultrasound parameters and ipsilateral cerebral hemisphere stroke in patients with moyamoya disease by logistic regression analysis.

Methods: In this retrospective case-control study, 88 patients with MMD (153 cerebral hemispheres) hospitalized in Beijing Tiantan Hospital, Capital Medical University from November 2020 to October 2021 were analyzed. According to the occurrence of stroke, the 153 cerebral hemispheres were divided into a stroke group and a non-stroke group. Clinical data and ultrasound parameters of the ipsilateral internal carotid artery, superficial temporal artery, maxillary artery, and posterior cerebral artery were recorded. The ultrasound parameters were divided into four groups according to interquartile range, and then they were compared between the stroke group and the non-stroke group. Those with significant differences were scored by multivariate logistic regression analysis.

Results: There were 75 cerebral hemispheres (49.0%) in the stroke group and 78 cerebral hemispheres (51.0%) in the non-stroke group. Logistic regression analysis showed that the internal diameter of the internal carotid artery, peak systolic velocity of the internal carotid artery and peak systolic velocity of the posterior cerebral artery were independently correlated factors for stroke in patients with MMD. The fourth quartile group of the above three ultrasound parameters was taken as the reference group, and the odds ratio of the first quartile group were 11.679 (95% CI 2.918-46.749, P = 0.001), 19.594 (95% CI 4.973-77.193, P < 0.001), and 11.657 (95% CI 3.221-42.186, P < 0.001), respectively.

Conclusion: Ultrasound parameters are independently correlated with ipsilateral cerebral stroke in patients with MMD. Ultrasound provides a new way to identify stroke in MMD patients. Future prospective cohort studies are needed to verify the clinical value of ultrasound in identifying patients with MMD at high risk of stroke.

Keywords: Internal carotid artery; Moyamoya disease; Posterior cerebral artery; Stroke; Ultrasound.