Judgement Value Of Superb Microvascular Imaging For Carotid Plaque Neovascularization And Correlation Study Of Ischemic Stroke

Part One Judgement value of superb microvascular imaging for carotid artery plaque neovascularizationOBJECTIVE: To investigate the value of superb microvascular imaging(SMI)in the detection of neovascularization in carotid plaques and to compare the results of contrast-enhanced ultrasound(CEUS)and dynamic contrast-enhanced MR imaging(MRI).METHODS: Patients with hypoechoic plaques were selected from the results of carotid ultrasonography.A total of 94 plaques were obtained,and SMI and CEUS were performed respectively.Thirty carotid plaques were examined by MRI.The results were compared with CEUS and MRI.The conformance Kappa test was used to verify the consistency between them and to determine the feasibility of SMI in detecting neovascularization.RESULTS: Neovascularization was found in 54 out of 94 plaques by SMI,while neovascularization was not found in 40 plaques.Neovascularization was found in 49 out of 94 plaques by CEUS,and the neovascularization detected by SMI was highly relative with the CEUS result at Kappa value of 0.783.Neovascularization was found in 16 out of 30 plaques by MRI,while neovascularization was not found in 14 plaques,and the neovascularization detected by SMI was relative with the MRI result at Kappa value of 0.591.CONCLUSION: SMI can detect neovascularization in plaque to determine the vulnerability of plaque,and have a good consistency with CEUS.MRI for plaque composition to pay more attention to the observation of lipid components,the sensitivity of the neovascularization in plaque is not as good as SMI and CEUS.Ultrasound angiography is more simple and easy to assess the vulnerability of plaque,and has an important reference value.Part Two Correlation between neovascularization and Ischemic stroke in carotid plaqueOBJECTIVE: To explore the risk factors of ischemic stroke and to assess the risk of ischemic stroke.METHODS: Patients with hypoechoic plaques were selected from the results of carotid ultrasonography.A total of 50 patients were enrolled in this study.The carotid plaque SMI was used to detect neovascularization in the plaque and the complete medical history of the patients,the results of the use of drugs and the results of head MRI / CT were collected.The risk factors were analyzed using Chi-square test.RESULTS: Smoking,plaque neovascularization and the occurrence of cerebrovascular accident has a correlation,the difference was statistically significant(P = 0.021,0.005).The formation of neovascularization in the plaque was related to diabetes mellitus,the difference was statistically significant(P = 0.014).CONCLUSION: Diabetic patients are prone to angiogenesis in carotid plaques,resulting in plaque instability.The formation of neovascularization in the plaque is associated with the occurrence of ischemic stroke,and the risk of ischemic stroke can be assessed by examining neovascularization within the plaque.