Department of Ultrasound Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China.
Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.
Korean J Radiol. 2018 Jan-Feb;19(1):15-22. doi: 10.3348/kjr.2018.19.1.15. Epub 2018 Jan 2.
To ascertain the feasibility of using shear wave velocity (SWV) in assessing the stiffness of carotid plaque by supersonic shear imaging (SSI) and explore preliminary clinical value for such evaluation.
Supersonic shear imaging was performed in 142 patients with ischemic stroke, including 76 males and 66 females with mean age of 66 years (range, 45-80 years). The maximum, minimum, and mean values of SWV were measured for 129 carotid plaques. SWVs were compared between echolucent and echogenic plaques. Correlations between SWVs and serum homocysteine levels were investigated. Based on neurological symptom, the surrogate marker of vulnerable plaque (VP), binary logistic regression was performed and area under curve (AUC) of homocysteine only and homocysteine combing SWV was calculated respectively.
Echogenic plaques (n = 51) had higher SWVs than echolucent ones (n = 78) (SWV 3.91 [3.24-4.17] m/s vs. 1.51 [1.04-1.94] m/s; SWV, 4.29 [3.98-4.57] m/s vs. 2.09 [1.69-2.41] m/s; SWV, 4.67 [4.33-4.86] m/s vs. 2.62 [2.32-3.31] m/s all values < 0.01). Pearson correlation analysis showed that stiffness of plaques was negatively correlated with homocysteine level. values for SWV, SWV, and SWV were -0.205, -0.213, and -0.199, respectively. Binary logistic regression analysis showed that sex ( = 0.008), low-density lipoprotein ( = 0.015), triglycerides ( = 0.011), SWV ( = 0.004), and hyper-homocysteinemia ( = 0.010) were significantly associated with symptomatic ischemic stroke. Receiver operating characteristic curves revealed that SWV combing serum homocysteine level (AUC = 0.67) presented better diagnostic value than serum homocysteine only (AUC = 0.60) for symptomatic ischemic stroke.
Supersonic shear imaging could be used to quantitatively evaluate stiffness of both echolucent and echogenic carotid plaques. More importantly, SWVs of plaques were not only correlated to serum homocysteine level, but also associated with symptomatic ischemic stroke, suggesting that SSI might be useful for understanding more about VP.
通过超声剪切波成像（SSI）确定使用剪切波速度（SWV）评估颈动脉斑块硬度的可行性，并探讨这种评估的初步临床价值。
对 142 例缺血性脑卒中患者进行了超声剪切波成像检查，包括 76 例男性和 66 例女性，平均年龄 66 岁（范围，45-80 岁）。测量了 129 个颈动脉斑块的 SWV 的最大值、最小值和平均值。比较了低回声斑块和强回声斑块之间的 SWV 值。研究了 SWV 与血清同型半胱氨酸水平之间的相关性。根据神经症状，采用二元逻辑回归分析，计算血清同型半胱氨酸和 SWV 联合的曲线下面积（AUC）。
强回声斑块（n = 51）的 SWV 值高于低回声斑块（n = 78）（SWV 3.91 [3.24-4.17] m/s 比 1.51 [1.04-1.94] m/s；SWV 4.29 [3.98-4.57] m/s 比 2.09 [1.69-2.41] m/s；SWV 4.67 [4.33-4.86] m/s 比 2.62 [2.32-3.31] m/s，所有 P 值均<0.01）。Pearson 相关分析显示，斑块的硬度与同型半胱氨酸水平呈负相关。SWV、SWV 和 SWV 的 值分别为-0.205、-0.213 和-0.199。二元逻辑回归分析显示，性别（ = 0.008）、低密度脂蛋白（ = 0.015）、甘油三酯（ = 0.011）、SWV（ = 0.004）和高同型半胱氨酸血症（ = 0.010）与症状性缺血性脑卒中显著相关。受试者工作特征曲线显示，SWV 联合血清同型半胱氨酸水平（AUC = 0.67）对症状性缺血性脑卒中的诊断价值优于血清同型半胱氨酸（AUC = 0.60）。
超声剪切波成像可用于定量评估低回声和强回声颈动脉斑块的硬度。更重要的是，斑块的 SWV 值不仅与血清同型半胱氨酸水平相关，还与症状性缺血性脑卒中相关，提示 SSI 可能有助于更深入地了解易损斑块。
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