Clinical Research Of Using Superb Micro-vascular Imaging To Assess Neovascularization In Carotid Atherosclerotic Plaque

Objective:1.To assess the effect of rosuvastatin on the neovascularization of carotid atherosclerotic plaque by superb micro-vascular imaging(SMI).2.To check the consistency of SMI and contrast-enhanced ultrasonography(CEUS)in assessing the neovascularization of carotid atherosclerotic plaque and investigate the clinical value of SMI.3.To analyze the relevance of the clinical symptoms and the neovascularization of carotid atherosclerotic plaque.4.To analyze the risk factors which were related to the neovascularization of carotid atherosclerotic plaque.Methods: 1.A total of 28 patients(including 33 plaques)with at least one plaque thickness ? 2.5 mm were selected from the inpatients of the second ward of neurology in Dalian Central Hospital Affiliated to Dalian Medical University.The clinical data,including sex,age,smoking history,drinking history,history of hypertension,history of diabetes mellitus,history of coronary heart disease,Body Mass Index(BMI),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),homocysteine(HCY)and fasting blood glucose were collected and recorded.2.All patients underwent SMI and CEUS examinations to assess the neovascularization of carotid plaque,recording and storing the images.Patients were instructed to take rosuvastatin 10mg/d regularly,low-fat diet,controlment of blood pressure and blood glucose during the treatment.After 6 months,review the neovascularization of the same location in the same plaque via SMI and CEUS,recording and storing the images.To analyze the change of the neovascularization in carotid atherosclerotic plaque before and after treatment.3.To check the consistency of SMI and CEUS in assessing the neovascularization in carotid atherosclerotic plaque according to the score of neovascularization in the same plaque.4.Patients were divided into symptomatic group and asymptomatic group according to the presence or absence of clinical symptoms such as TIA or cerebral infarction,and the relevance of the clinical symptoms and plaque neovascularization were analyzed.5.Analysis the plaque neovascularization and cerebrovascular disease risk factors.Results: 1.A total of 33 plaques were detected in the 28 patients.Before treatment,the score of 4 patients about the neovascularization in carotid atherosclerotic plaque were 0,10 patients were 1,16 patients were 2,3 patients were 3 by SMI.The score of 4 patients about the neovascularization in carotid atherosclerotic plaque were 0,16 patients were 1,7 patients were 2,6 patients were 3 by CEUS.After treatment(one patient died of lung cancer and did not complete the follow-up review),the score of 8 patients about the neovascularization in carotid atherosclerotic plaque were 0,15 patients were 1,7 patients were 2,2 patients were 3 by SMI.The score of 7 patients about the neovascularization in carotid atherosclerotic plaque were 0,17 patients were 1,8 patients were 2,0 patients were 3 by CEUS.Kappa value was used to check the consistency of SMI and contrast-enhanced ultrasonography(CEUS)in assessing the neovascularization in carotid atherosclerotic plaque,confirming that SMI had high consistency with CEUS(before treatment ?=0.621,after treatment ?=0.610).2.Before treatment with rosuvastatin,the score of 4 patients about the neovascularization in carotid atherosclerotic plaque were 0,10 patients were 1,15 patients were 2,3 patients were 3 by SMI.After treatment with rosuvastatin,the score of 8 patients about the neovascularization in carotid atherosclerotic plaque were 0,15 patients were 1,7 patients were 2,2 patients were 3 by SMI.Plaque neovascularization score before treatment was 2.0(1.0-2.0)and 1.0(0.25-2.0)after treatment.Wilcoxon signed rank sum test was used to analyze the changes of neovascularization in the plaques before and after treatment.The results were statistically significant(P = 0.002,P <0.05),indicating that plaque neovascularization was reduced after rosuvastatin treatment.3.Of the 28 patients,there were 13 symptomatic patients,including 1 patient was 0,2 patients were 1,7 patients were 2,3 patients were 3 by SMI.And there were 15 asymptomatic patients,including 3 patients was 0,5 patients were 1,7 patients were 2,0 patient was 3 by SMI.Plaque neovascularization score was 2.0(1.5-2.5)of the symptomatic group and 1.0(1.0-2.0)of the asymptomatic group.Using two independent samples Mann-Whitney U test analysis,the results were statistically significant(P = 0.044,P <0.05),indicating that the plaque neovascularization score was related to the clinical symptoms and the neovascularization score of the symptomatic group was higher than the asymptomatic group.4.Among the 28 patients,24 had neovascularization and 4 had no neovascularization.The results of statistical analysis confirmed that there were no significant difference of the cerebrovascular disease risk factors between the two groups(P> 0.05).Conclusions: 1.There was a high consistency of SMI and CEUS in the assessment of the neovascularization in carotid atherosclerotic plaques.SMI can assess the neovascularization in carotid atherosclerotic plaques accurately,simply and conveniently.2.Rosuvastatin treatment can reduce the number of neovascularization in carotid atherosclerotic plaque,and its efficacy can be monitored by SMI.3.The plaque neovascularization score was related to the clinical symptoms and the neovascularization score of the symptomatic group was higher than the asymptomatic group.