The Value Of Essen Score Combined With Carotid Plaque Contrast-enhanced Ultrasound In Predicting The Risk Of Recurrence Of Ischemic Stroke

OBJECTIVE:To explore whether Essen score combined with contrast-enhanced ultrasonography and time-intensity curve quantitative analysis of carotid plaque can improve the predictive efficiency of ischemic stroke recurrence.METHODS:Patients with primary ischemic stroke treated in our hospital from August 2017 to February 2019 were evaluated with Essen scale,contrast-enhanced ultrasonography and time-intensity curve(TIC)quantitative analysis of carotid plaque.The relevant parameters of contrast-enhanced ultrasound were obtained: plaque neovascularization grade,enhancement intensity(EI),plaque / lumen enhancement ratio(Ratio),arrive time(AT),peak time(PT).Follow-up for 12 months,according to whether recurrent ischemic stroke was divided into the recurrent group and the non-recurrent group,of which 3 cases lost follow-up,and finally 150 cases were selected.The correlation between the parameters related to contrast-enhanced ultrasound and the recurrence of ischemic stroke was analyzed,and the predictive efficiency of contrast-enhanced ultrasound combined with Essen score in predicting the recurrence of ischemic stroke was tested.RESULTS:1.There were 64 cases in the recurrent group and 86 cases in the non-recurrent group.There was no significant difference in gender between the two groups(c 2=0.018,P=0.893).The average age in the recurrent group was higher than that in the non-recurrent group(70.81±8.05 vs 65.49±10.32 years),and the difference was statistically significant(t=3.424,P=0.001).The age cutoff value was 70 years old.2.There was no significant difference in the proportion of smoking,coronary heart disease,dyslipidemia,diabetes and drinking history between the recurrent group and the non-recurrent group(all P >0.05).The incidence of hypertensive disease in the recurrent group was higher than that in the non-recurrent group(c2= 6.445,P=0.011).3.The Essen score in recurrent group was significantly higher than that in non-recurrent group(3.36 ±1.19 vs 2.08 ±0.87).4.There was no significant difference in NIHSS score between the recurrent group and the non-recurrent group at admission(t=0.295,P=0.768),and there was no significant difference in the constituent ratio of ? 3 points between the two groups(c2=0.128,P=0.721).5.There was no significant difference in plaque length and thickness between recurrent group and non-recurrent group(all P > 0.05).6.The grade of plaque neovascularization in recurrent group was higher than that in non-recurrent group(Z=3.897,P=0.000),TIC curveanalysis: there was no significant difference in AT and PT between the two groups(all P > 0.05).Ratio and EI of plaque in recurrent group were significantly higher than those in non-recurrent group(all P<0.05).7.Multivariate Logistic regression analysis showed that plaque neovascularization grade,EI,ratio and Essen score were independently correlated with IS recurrence.8.According to the ROC curve analysis,the area under the curve predicted by EI and ratio was similar to the Essen score(all P > 0.05),but the area under the neovascularization grade curve was the smallest,and The area under the curve of the three combined variables(Essen score,EI,neovascularization grade)is the largest,and the difference is statistically significant compared with the prediction of individual variables(all P <0.05).9.The sensitivity and specificity of Essen score(cutoff value> 2),neovascularization grade(cutoff value> II),EI(cutoff value>23),Ratio(cutoff value>0.121)and three combined variables in predicting the recurrence of ischemic stroke were 79.3%?69.1%,77.4%?54.1%,64.1%?94.2%,70.3%?88.4%,81.4%?93.2%.CONCLUSION:1.Carotid plaque neovascularization grade,EI and Ratio are all important parameters reflecting the number of neovascularization,and therecurrent group is higher than the non-recurrent group,suggesting that plaque neovascularization is an independent risk factor for the recurrence of ischemic stroke.2.ROC curve analysis showed that the efficacy of EI,ratio and Essen score in predicting the risk of recurrent ischemic stroke was similar,the efficacy of neovascularization grade was the lowest,and the combination of Essen score,EI and neovascularization grade was better.3.Essen score combined with carotid plaque contrast-enhanced ultrasonography and TIC curve quantitative analysis of neovascu larization can significantly improve the predictive efficiency of stroke recurrence risk.