| Objective:Recent researches have shown that new vessels in plaque is directly associated with plaque stability,and new vessels:in plaque can stimulate the growth of plaque.The objectives of this study was to research and analyze the presence of new vessels in carotid plaque and their density by ultrasound,superb microvasclar imaging(SMI)and contrast enhanced ultrasound(CEUS)in both qualitative and quantitative ways,discuss the value of SMI in diagnosing new vessels in carotid plaque,and provide reliable diagnostic basis for judging the vulnerability of plaque and predicting plaque stability in clinic.Methods:Outpatients and inpatients in the Affiliated Hospital of Yanbian University from June 2015 to January 2017,whose inner length of carotid artery was greater than 15mm and target plaque thickness were greater than 3mm as shown in ultrasound screening,were selected.First,conventional ultrasonic examination of carotid artery was carried out to determine plaque location and echo,and superb microvascular imaging(SMI)and contrast-enhanced ultrasound examination were performed to make a quantitative and qualitative analysis of the distribution and location of new vessels in the target plaque,and scoring was conducted according to the number of new-vessels.After completing contrast-enhanced ultrasound operation,SMI was carried out again on the target plaque.With the ultrasound contrast or plaque pathological result as the golden criterion for evaluating the distribution and number of new vessels in plaque,the consistency between SMI and contrast-enhanced ultrasound examination were statistically analyzed in terms of scores of distribution and number of new vessels in carotid plaque.Finally,an overall judgement was made on the vulnerability of carotid plaque assessed by contrast-enhanced ultrasound,SMI and conventional ultrasound.Result:A total of 51 patients(71 plaques)were enrolled.The detection rates of ultrasound contrast and SMI for new vessels in plaque were 94%(67/71)and 85%(61/71)respectively(K?0.6),suggesting medium consistency.The new vessel scores of ultrasound contrast and SMI showed that 4 and 10 cases got zero,12 and 13 cases got one point,26 and 27 cases got 2 points,and 26 and 23 cases got 3 points respectively;0-3 points(K>0.8)showed good consistency between the two examination methods;0-1 points(K?0.4)showed poor consistence;2-3 points(K>0.8)showed good consistency.Among the 12 patients(19 plaques)in the 0-1 point group,there were 2 with ischemic cerebral stroke,1 with transient cerebral ischemia(TIA)and 9 cases with other conditions;the 19 plaques included 8 with hypoechoic plaque,9 with mixed echo plaque and 2 with hyperechoic plaque;in terms of CEUS score,4 cases got zero,15 cases got 1 point and 1 case suffered from TIA during follow-up.Among the 39 patients(52 plaques)in the 2-3 point group,there were 21 with ischemic cerebral stroke,6 with TIA and 12 with other conditions;among the 52 plaques(in terms of CEUS score,27 plaques got 2 points and 25 plaques got 3 points),there were 4 cases with intraplaque hemorrhage,2 with superficial ulcer,33 with hypoechoic plaque,and 13 with mixed echo plaques;3 patients suffered from ischemic cerebral stroke during follow-up.Conclusions:(1)Conventional ultrasound cannot identify whether there are new vessels in plaque;the score of IPN number of SMI for carotid plaque was 0-1 point,and there is poor consistency between diagnostic rate of new vessels and CEUS score;the score of SMI for IPN in carotid plaque is 2-3 points,and there is good consistency between diagnostic rate of new vessels and CEUS score.(2)The score of number of IPN in carotid plaque was 2 to 3 points,and its incidence rate of cerebral arterial thrombosis is higher than that of the 0-1 point group.(3)The judgement of new vessels in plaque by SMI can help judge whether they are vulnerable plaques and provide reliable diagnostic evidence for predicting plaque stability in clinic. |
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