The Clinical Value Of Contrast-enhanced Ultrasound In The Evaluation Of Carotid Plaque Stability

Objective: This study focused on by Contrast-enhanced ultrasonography of the carotids showed the neovascularization in the carotid artery atherosclerotic plaques to assess the stability of carotid atherosclerotic plaques.Methods: The patients selected from January 2017 to February 2018 both did conventional carotid Doppler ultrasonography and Contrast-enhanced ultrasonography examination,a total of 78 cases,54 cases of men,24 cases of women,aged 59 to 86,average age 68.Application of Esaote My Lab Class C ultrasonic diagnostic instrument line array probe LA523 respectively on 78 patients undergoing conventional two-dimensional carotid ultrasound examination,and the observed plaques were divided into were divided into soft plaque group?mixed plaque group and hard plaque group according to the acoustic characteristics.Ultrasonic contrast agent(Bracco Suisse SA)Sono Vue powder(Contain 59 mg SF6 gas),mix 5.0 ml 0.9% Na Cl,shake forcibly,getting white emulsion mixed suspension micro bubble contrast agent.Then replace the probe for linear array probe LA332,enabling low mechanical index(MI = 0.07)and double amplitude imaging model,through the the elbow vein bolus 2.5 ml micro bubble contrast agent,immediately push 5 ml 0.9% Na Cl flushing.Observe different enhancement within the types of carotid plaques and the degree of stenosis lumen in three groups patients.Results: ?A total of 78 plaques were detected by conventional two-dimensional ultrasonography,and the total number of plaques detected by Contrast-enhanced ultrasonography was 80;Contrast-enhanced ultrasonography revealed two low-echo plaques that were omitted from conventional carotid Doppler ultrasonography examination.?Of the 80 plaques,32 soft plaques were enhanced with 28(enhancement rate of 87.5),34 mixed plaques were enhanced with 27(enhancement rate of 79.4),None of the 14 hard plaques were enhanced.The enhancement ratio was significantly higher in soft plaques and mixed plaques group than in the hard plaques group,the difference was statistically significant(P<0.001),but there was no statistically significant difference between the soft plaques group and the mixed plaques group(P>0.05).?The conventional carotid Doppler ultrasonography showed 13 cases of artery stenosis and 1 case of artery occlusion,while Contrast-enhanced ultrasonography of the carotids showed that 10 of these patients' s artery stenosis' s degree was reduced than before,the difference was 8.07%±8.89%.Conclusion: Contrast-enhanced ultrasound can show the neovascularization in the plaques,and the evaluation of vulnerable plaques can be more complete,while the low non-echo plaques that are omitted from the conventional color ultrasound can also be found to improve the detection rate of the plaques.At the same time,the stenosis of vascular lumen can be evaluated more accurately.