The clinical value of carotid contrast-enhanced ultrasound in assessment of intraplaque neovascularization of atherosclerotic plaques

Abstract

Objective To investigate the value of predicting the vulnerability of atherosclerotic plaques in assessment of intraplaque neovascularization using carotid contrast-enhanced ultrasound. Methods A total of 24 cases diagnosed as moderate to severe carotid stenosis by digital subtraction angiography (DSA) underwent carotid endarterectomy (CEA) from September 2017 to October 2018. Preoperative carotid contrast-enhanced ultrasound and postoperative pathological examination were performed in the patients. Results Compared with postoperative pathological results, 22 cases were clearly diagnosed by preoperative carotid contrast-enhanced ultrasound, and 2 cases were missed. The precision rate of preoperative diagnosis was 91.67% (22/24). Meanwhile carotid plaques were divided into four grades (Grade Ⅰ-Ⅳ) according to the degree of enhancing extent of contrast-enhanced ultrasound. Each grade included 6 cases (25%). Pearson correlation analysis showed there was an evidently positive correlation between preoperative grade of carotid plaques and number of intraplaque CD34-positive neovessels (r = 0.871, P = 0.000). The value of area under the curve (AUC) was 0.927 (95% CI: 0.848-1.006, P = 0.000). Conclusions The grade of carotid plaques was positively related to intraplaque CD34-positive neovessels. Hence, carotid contrast-enhanced ultrasound plays an important role in predicting the vulnerability of atherosclerotic plaques and risk of ischemic stroke and judging optimal surgical time.

DOI: 10.3969/j.issn.1672-6731.2019.03.009