Clinical value of atherosclerotic plaque fibrous cap integrity observed by ultrasound

Abstract

Objective To retrospectively analyze carotid ultrasonography detection results in patients with unilateral anterior circulation acute ischemic stroke, and to observe the influence of atherosclerotic plaque fibrous cap integrity on plaque stability. Methods In the long axis and the short axis of color Doppler ultrasonograpy, carotid artery wall, atherosclerotic plaques and the integrity of fibrous cap, as well as the number of plaques with low, medium and strong echo in unilateral carotid artery were observed and recorded, so as to judge the hemodynamic situation of stenosis artery. Results A total of 215 plaques were found in 86 patients, among whom 77 patients with incomplete fibrous cap, 72 cases with low echo plaques and 5 cases with medium echo plaques (χ2 = 37.703, P = 0.000). There were 46 cases with incomplete fibrous cap in the affected side and 31 cases with incomplete fibrous cap in the uninjured side (χ2 = 5.291, P = 0.021); 56 cases with low echo plaques in affected side and 44 cases with low echo plaques in uninjured side (χ2 = 0.168, P = 0.682). Fifteen cases presented carotid artery stenosis caused by low echo plaques located in initial part of internal carotid artery (10 cases), carotid bifurcation (4 cases) and external carotid artery (1 case). There was significant difference (χ2 = 3.900, P = 0.048) between carotid bifurcation (8.16%, 4/49) and initial part of internal carotid artery (27.03%, 10/37). Conclusions The relationship between atherosclerotic plaque fibrous cap integrity and stroke is close. Plaques with incomplete fibrous cap are mainly low echo plaques. Therefore, ultrasonic evaluation of plaque echo and fibrous cap integrity can judge the stability of plaque. Besides, it is more significant to examine fibrous cap integrity than simply assess plaque echo features clinically. doi：10.3969/j.issn.1672-6731.2014.02.003