The Value Of Routine Ultrasound Combined With Superb Microvascular Imaging In Evaluating The Stability Of Carotid Artery Plaque

Part ?The application value of superb microvascular imaging in the detection of neovascularization in carotid atherosclerotic plaqueObjectiveTo detect neovascularization in carotid atherosclerotic plaques by novel superb microvascular imaging(SMI)technique and to explore the value of SMI in evaluating plaque vulnerability.MethodsA total of 157 carotid atherosclerotic plaques in 95 patients were examined by SMI.The semi-quantitative scoring system was used to scan and classify the new blood flow in the plaques.Meanwhile,cross-check analysis routine ultrasonic appearance with contrast-enhanced ultrasound(CEUS)was performed to compare the consistency of the two results.ResultsThe incidence of neovascularization in the plaques detected by SMI was 58.59%(92/157),while the date detected by CEUS was 58.59%(92/157).The difference was not statistically significant(P>0.05).The comparison of the data from SMI experiment and the results from the CEUS equations show good consistency.(Kappa=0.839,P < 0.01).ConclusionThe superb microvascular imaging technique can accurately evaluate the neovascularization and is feasible,effective and accurate,which provides important basis for clinical evaluation of plaque vulnerability.Part ? Diagnostic value of ultrasound combined with SMI for evaluation of carotid plaque stabilityObjectiveCompare the accuracy of routine ultrasound and SMI in the diagnosis of carotid atherosclerotic plaque stability,and explore the diagnostic value of ultrasound combined with SMI in evaluating the stability of the plaques.MethodsA total of 46 carotid atherosclerotic plaques in 43 patients were enrolled.Parameter indicators that represent vulnerability of plaques were evaluated by routine ultrasound and SMI.Meanwhile,cross-check analysis ultrasonic appearance with HRMRI was performed to compare the consistency of the two results.ResultsRoutine ultrasound combined with SMI has its own characteristics in the diagnosis of carotid atherosclerotic plaques,including fibrous cap continuity,plaque composition and neovascularization in plaques.The comparison of the data of unstable plaques from SMI experiment and the results from the HRMRI equations show good consistency.(Kappa=0.775,P < 0.01).ConclusionUltrasound combined with SMI technique offer new imaging indicators and new feature parameters for the characterization of carotid atherosclerotic plaques,and provide important iconography evidence for evaluating the vulnerability of carotid atherosclerotic plaques.Part ? The application of ultrasound combined with SMI technology in the evaluation for the therapeutic effect of plaque stability on patients with type 2diabetes complicated with coronary heart diseaseObjectiveTo analyze therapeutic effect of plaque stability on patients with type 2 diabetes complicated with coronary heart disease,and to investigate the application value of ultrasound combined with SMI in the assessment of curative effect of carotid artery plaque.MethodsA total of 117 patients with carotid atherosclerotic plaques were included in the trial.All patients were both suffering from type 2 diabetes and coronary heart disease,and they were randomly divided into “atorvastatin group”(atorvastatin 40 mg/day)and“combined group”(20 mg/d atorvastatin and ezetimibe 10 mg/d).The specimen were followed up for 12 months.The changes of serum lipid metabolism before and after treatment were observed.The morphology,size and plaque stability of carotid artery plaque were evaluated by ultrasound combined with SMI.ResultsAfter 12 months of treatment,the lipid profiles of the two groups were significantly improved,and the levels of TC,TG,LDL-C,hs-CRP,FPG and Hb A1 c were significantly decreased compared with those data before treatment(P<0.01).There was no significant difference in the thickness of carotid artery intima.The size and area of carotid atherosclerotic plaque in the two groups were better than those before the treatment(P <0.05).The incidence of vulnerable plaque in “atorvastatin group”decreased from 74.57%before treatment to 66.10% and there was no significant difference in plaque stability between before and after treatment((34)2=0.235,P >0.05).While the incidence of vulnerable plaque in “combined group”decreased to 39.70% from 72.06% before treatment and there was significant difference in plaque stability between before and after treatment((34)2=9.378,P<0.01).ConclusionThe blood lipid profiles in patients with diabetes and coronary heart disease were all significantly ameliorated on both “combined group” and “atorvastatin group”.The therapeutic effect of the “combined group” on the stability of plaque was better than that of the“atorvastatin group”.There were no obvious side effects in the two groups,which showed good safety.Carotid artery ultrasound combined with SMI can assess the stability of carotid artery plaque,which provides imaging support for the selection of clinical treatment options and evaluation of the therapeutic effect.