| Objective: 1.To explore the two-dimensional and contrast-enhanced ultrasound characteristics of carotid plaque in patients with acute cerebral infarction,and to evaluate its value in the diagnosis of unstable plaque.2.To analyze the contrast-enhanced ultrasound characteristics of carotid plaque in patients with recurrent cerebral infarction.3.To analyze the risk factors of recurrent cerebral infarction and to evaluate its value in predicting the risk of recurrent cerebral infarction.Methods: 1.The patients with acute cerebral infarction hospitalized in the department of Neurology of the First Affiliated Hospital of Jinan University from October 2017 to May 2018 were collected,and the ultrasound examination of the carotid artery showed that the thickness of the plaque on the carotid wall on the side of the patient with acute cerebral infarction was more than 2mm,who was the acute cerebral infarction group with a total of 68 cases.In the same time,39 patients with thickness of carotid plaque greater than 2mm without cerebrovascular events were taken as the control group.And those with acute cerebral infarction were divided into 11 patients with recurrent ischemic cerebrovascular events and 57 patients with non-recurrent ischemic cerebrovascular events within 18 months of follow-up.2.The general clinical data and the data of laboratory examination of all patients were collected.All patients needed to be performed cranial magnetic resonance imaging(MRI)or computed tomography(CT)to determine whether there was acute cerebral infarction lesion.3.All eligible patients were taken two-dimensional ultrasound examination and contrast-enhanced ultrasound examination of carotid artery within one week after admission.4.The thickness,area and echo of the dominant plaque were recorded by two-dimensional ultrasound examination.And semi-quantitative grade of the enhancement of neovascularization in the plaque was evaluated by contrast-enhanced ultrasound.The time-intensity curve(TIC)was used to quantitatively analyze the neovascularization.5.SPSS 22.0 statistical software was used to analyze the differences between groups.Results: 1.The area of the plaque in acute cerebral infarction group was 18.88 ±14.18 mm2,which was significantly higher than that in control group(13.10 ±8.43 mm2),the difference was statistically significant(P<0.05).In acute cerebral infarction group,the proportion of plaque enhancement mode of grade 3(38 cases,55.88%)was the highest,and that of grade 1(14 cases,20.59%)was the lowest.While in the control group,the proportion of plaque enhancement mode of grade 1(15 cases,39.47%)was the highest,and that of grade 3(11 cases,28.95%)was the lowest,and the difference was statistically significant(P<0.05).The quantitative analysis curve showed that the ratio of enhanced intensity of the plaque in the acute cerebral infarction group was 0.44 ±0.71,which was higher than that in the control group(0.27 ±0.19),and the difference was statistically significant(P<0.05).2.In the non-recurrent group,the proportion of plaque enhancement mode of grade 3(35 cases,61.40%)was the highest,while the proportion of grade 2(6 cases,54.55%)in the recurrent group was the highest,and the difference was statistically significant(P<0.05).The quantitative analysis curve showed that the time to peak in recurrent acute cerebral infarction group was 34.90 ±19.46 s,which was significantly longer than the time to peak(27.09 ±8.03s)in non-recurrent acute cerebral infarction group(P<0.05).3.The proportion of smoking history and the data of hypersensitive C-reactive protein in acute cerebral infarction group were significantly higher than those in the control group(P<0.05).The age,systolic blood pressure,percentage of monocytes and total cholesterol in the recurrent group were significantly higher than those in the non-recurrent group(P < 0.05).Logistic regression analysis showed that total cholesterol was a risk factor for recurrence of cerebral infarction(OR=1.23,95% CI:1.062-1.433).Conclusions: The larger the two-dimensional area of carotid plaque,the higher the risk of acute cerebral infarction.The higher the degree of enhancement grade in contrast-enhanced ultrasound and the ratio of enhanced intensity,the higher the incidence of acute cerebral infarction.The ratio of enhanced intensity,the quantitative index of contrast-enhanced ultrasound,can be used to evaluate neovascularization density more objectively.Contrast-enhanced ultrasound shows that neovascularization density of plaque in the recurrent group is lower than that in the non-recurrent group,suggesting that other vulnerable components in the plaque and neovascularization may lead to the recurrence of acute cerebral infarction,which needs a further study. |
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