Value of combined exploration of carotid plaque by multiple ultrasound techniques to predict recurrence of ischemic stroke

ZHANG Qian; MIAN Li; WANG Xia

doi:10.16766/j.cnki.issn.1674-4152.003600

Volume 22 Issue 7

Jul. 2024

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Article Navigation > Chinese Journal of General Practice > 2024 > 22(7): 1204-1208

ZHANG Qian, MIAN Li, WANG Xia. Value of combined exploration of carotid plaque by multiple ultrasound techniques to predict recurrence of ischemic stroke[J]. Chinese Journal of General Practice, 2024, 22(7): 1204-1208. doi: 10.16766/j.cnki.issn.1674-4152.003600

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ZHANG Qian, MIAN Li, WANG Xia. Value of combined exploration of carotid plaque by multiple ultrasound techniques to predict recurrence of ischemic stroke[J]. Chinese Journal of General Practice, 2024, 22(7): 1204-1208. doi: 10.16766/j.cnki.issn.1674-4152.003600

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Value of combined exploration of carotid plaque by multiple ultrasound techniques to predict recurrence of ischemic stroke

doi: 10.16766/j.cnki.issn.1674-4152.003600

Ultrasound Diagnosis Department, the Second Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, Xinjiang 830063, China

Funds:

SKL-HIDCA-2022-NKX8

Received Date: 2024-03-08
Available Online: 2024-09-05

Abstract

Abstract

Objective To investigate the value of combined 2D and 3D ultrasound, contrast-enhanced ultrasonography (CEUS) and shear-wave elastography (SWE) for the detection of carotid plaques, and to analyze their value in predicting recurrence of ischaemic stroke (IS). Methods A total of 95 patients with first-ever IS and carotid atherosclerotic plaque from October, 2021 to January, 2023 in the Second Affiliated Hospital of Xinjiang Medical University were selected, and divided into a recurrence group and a non-recurrence group according to whether they had recurred or not. Risk factors for relapse in patients with IS were analyzed using logistic regression. Receiver operating characteristic (ROC) curves were used to analyze the value of different ultrasound techniques in predicting the recurrence of IS. Results Five cases were lost to follow-up. The recurrence rate was 41.11%, and there were no deaths after treatment. The proportion of hypertension in the recurrent group was higher than that in the non-recurrent group, and the proportion of good medication compliance was lower than that in the non-recurrent group (P < 0.05). The ratio of CEUS blood flow grade Ⅲ to Ⅳ, 2-D intima-media thickness (IMT) and 3-D-TPA in the recurrent group were higher than those in the non-recurrent, while the mean Young's modulus was lower than that in the non-recurrent group (P < 0.05). Multivariate logistic regression analysis showed that CEUS blood flow level Ⅲ to Ⅳ, high 2-IMT, large 3-3D total carotid plaque area (TPA) and low mean Young's modulus were risk factors for recurrence in IS patients, and good medication compliance was a protective factor (P < 0.05). ROC curve analysis showed that the AUC of 2-D IMT, 3-D TPA, mean Young's modulus and CEUS blood flow Ⅲ to Ⅳ in predicting recurrence of in IS patients were 0.674, 0.717, 0.729 and 0.746, respectively. The combined predictive AUC of 0.908 was higher than that of single detection (P < 0.05). Conclusion 2D, 3D and SWE and CEUS ultrasound techniques have some clinical value in predicting the recurrence of IS by evaluating carotid plaque instability, and the combined value of the four is higher.
- Ischemic stroke,
- Carotid artery plaque,
- Three-dimensional ultrasound,
- Contrast-enhanced ultrasound,
- Shear-wave elastography

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[1]	《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告2020》概要[J]. 中国脑血管病杂志, 2022, 19(2): 136-144. https://www.cnki.com.cn/Article/CJFDTOTAL-NXGB202311009.htm Report on stroke prevention and treatment in China Writing Group. Brief report on stroke prevention and treatment in China, 2020[J]. Chinese Journal of Cerebrovascular Diseases, 2019, 19(2): 136-144. https://www.cnki.com.cn/Article/CJFDTOTAL-NXGB202311009.htm
[2]	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2022概要[J]. 中国循环杂志, 2023, 38(6): 583-612. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH202407010.htm The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases in China 2022: an updated summary[J]. Chinese Circulation Journal, 2023, 38(6): 583-612. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH202407010.htm
[3]	汤爱洁, 牛淑珍, 刘怡凡, 等. 基于倾向性评分匹配法评估急性缺血性脑卒中神经功能改善的影响因素分析[J]. 中华全科医学, 2022, 20(2): 186-189. doi: 10.16766/j.cnki.issn.1674-4152.002308 TANG A J, NIU S Z, LIU Y F, et al. Analysis of the influencing factors of neurological improvement in acute ischemic stroke on the basis of propensity score matching[J]. Chinese Journal of General Practice, 2002, 20(2): 186-189. doi: 10.16766/j.cnki.issn.1674-4152.002308
[4]	ZHOU F, HUA Y, JI X, et al. A systemic review into carotid plaque features as predictors of restenosis after carotid endarterectomy[J]. J Vasc Surg, 2021, 73(6): 2179-2188.
[5]	KASHIWAZAKI D, YAMAMOTO S, AKIOKA N, et al. Dilated microvessel with endothelial cell proliferation involves intraplaque hemorrhage in unstable carotid plaque[J]. Acta Neurochir (Wien), 2021, 163(6): 1777-1785.
[6]	ZHANG Y, CAO J, ZHOU J, et al. Plaque elasticity and intraplaque neovascularisation on carotid artery ultrasound: a comparative histological study[J]. Eur J Vasc Endovasc Surg, 2021, 62(3): 358-366.
[7]	ZAMANI M, SKAGEN K, SCOTT H, et al. Advanced ultrasound methods in assessment of carotid plaque instability: a prospective multimodal study[J]. BMC Neurol, 2020, 20(1): 39.
[8]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJB201911024.htm Chinese Society of Neurology; Chinese Stroke Society. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018[J]. Chinese Journal of Neurology, 2018, 51(9): 666-682. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJB201911024.htm
[9]	黄雅萍, 侯放, 文晟, 等. 超声造影诊断颈动脉不稳定斑块破裂风险的效能[J]. 中国超声医学杂志, 2023, 39(1): 5-8. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY202301002.htm HUANG Y P, HOU F, WEN S, et al. Efficacy of contrast-enhanced ultrasound in diagnosing the risk of carotid artery unstable plaque rupture[J]. Chinese Journal of Ultrasound Medicine, 2019, 39(1): 5-8. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY202301002.htm
[10]	CHALOS V, VAN DER ENDE N A M, LINGSMA H F, et al. National institutes of health stroke scale: an alternative primary outcome measure for trials of acute treatment for ischemic stroke[J]. Stroke, 2020, 51(1): 282-290.
[11]	SCHINKEL A F L, BOSCH J G, STAUB D, et al. Contrast-Enhanced ultrasound to assess carotid intraplaque neovascularizatione[J]. Ultrasound Med Biol, 2020, 46(3): 466-478.
[12]	$\overline{\mathrm{S}}$KOLOUDÍK D, KE$\overline{\mathrm{S}}$NEROVÁ P, VOMÁČKA J, et al. Shear-Wave elastography enables identification of unstable carotid plaque[J]. Ultrasound Med Biol, 2021, 47(7): 1704-1710. https://www.cnki.com.cn/Article/CJFDTOTAL-TJIY202404007.htm
[13]	KABŁAK-ZIEMBICKA A, PRZEWŁOCKI T. Clinical significance of carotid intima-media complex and carotid plaque assessment by ultrasound for the prediction of adverse cardiovascular events in primary and secondary care patients[J]. J Clin Med, 2021, 10(20): 4628. DOI: 10.3390/jcm10204628.
[14]	YOON H J, KIM K H, PARK H, et al. Carotid plaque rather than intima-media thickness as a predictor of recurrent vascular events in patients with acute ischemic stroke[J]. Cardiovasc Ultrasound, 2017, 15(1): 19. DOI: 10.1186/s12947-017-0110-y.
[15]	HENSLEY B, HUANG C, CRUZ MARTINEZ C V, et al. Ultrasound measurement of carotid intima-media thickness and plaques in predicting coronary artery disease[J]. Ultrasound Med Biol, 2020, 46(7): 1608-1613.
[16]	张莉, 李安洋, 郭磊, 等. 颈动脉斑块彩色多普勒超声联合头颈部CTA诊断缺血性脑卒中患者颈动脉狭窄临床价值[J]. 医学影像学杂志, 2023, 33(8): 1477-1480. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ202308036.htm ZHANG L, LI A Y, GUO L, et al. Clinical value of color Doppler ultrasound combined with head and neck CTA in diagnosing carotid artery stenosis in patients with ischemic stroke[J]. Journal of Medical Imaging, 2023, 33(8): 1477-1480. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ202308036.htm
[17]	ZHANG S, JIANG S, WANG C, et al. Comparison of ultrasonic shear wave elastography, AngioPLUS planewave ultrasensitive imaging, and optimized high-resolution magnetic resonance imaging in evaluating carotid plaque stability[J]. Peer J, 2023, 11: e16150. DOI: 10.7717/peerj.16150.
[18]	GOUDOT G, SITRUK J, JIMENEZ A, et al. Carotid plaque vulnerability assessed by combined shear wave elastography and ultrafast doppler compared to histology[J]. Transl Stroke Res, 2022, 13(1): 100-111.
[19]	宫文亮, 周建, 朱道伟. 超声造影联合剪切波弹性成像评估乳腺癌病灶可切除性的研究[J]. 影像科学与光化学, 2022, 40(6): 1375-1380. https://www.cnki.com.cn/Article/CJFDTOTAL-GKGH202206011.htm GONG W L, ZHOU J, ZHU D W. Evaluation of resectability of breast cancer lesions by contrast-enhanced ultrasound combined with shear wave elastography[J]. Imaging Science and Photochemistry, 2022, 40(6): 1375-1380. https://www.cnki.com.cn/Article/CJFDTOTAL-GKGH202206011.htm
[20]	JOO S P, LEE S W, CHO Y H, et al. Vasa vasorum densities in human carotid atherosclerosis is associated with plaque development and vulnerability[J]. J Korean Neurosurg Soc, 2020, 63(2): 178-187.
[21]	CAMPS-RENOM P, PRATS-SÁNCHEZ L, CASONI F, et al. Plaque neovascularization detected with contrast-enhanced ultrasound predicts ischaemic stroke recurrence in patients with carotid atherosclerosis[J]. Eur J Neurol, 2020, 27(5): 809-816.
[22]	刘燕霞, 郭林佳, 王俐元, 等. 北京市缺血性脑卒中复发高危患者健康信念及二级预防现状调查[J]. 中国社会医学杂志, 2022, 39(6): 671-675. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSY202206015.htm LIU Y X, GUO L J, WANG L Y, et al. Investigation on health belief and secondary prevention status of patients at high risk of recurrent ischemic stroke in Beijing[J]. Chinese Journal of Social Medicine, 2022, 39(6): 671-675. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSY202206015.htm

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Value of combined exploration of carotid plaque by multiple ultrasound techniques to predict recurrence of ischemic stroke

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