Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Beijing, China.
Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Beijing, China.
Ultrasound Med Biol. 2021 Feb;47(2):244-251. doi: 10.1016/j.ultrasmedbio.2020.09.025. Epub 2020 Nov 3.
The aim of this study was to identify the ultrasound-based carotid plaque characteristics associated with new cerebral ischemic lesions after carotid endarterectomy (CEA). Between January 2013 and December 2018, carotid duplex ultrasound was performed in 1061 patients who underwent CEA. Brain magnetic resonance diffusion-weighted imaging (DWI) was performed pre-operatively and within 30 d after CEA. New cerebral ischemic lesions on DWI were observed in 169 patients. The cutoff value gray-scale median (GSM) used to distinguish DWI-positive from DWI-negative patients was 30.5, with an area under the receiver operating characteristic curve of 0.837. A larger proportion of multiple DWI lesions were observed in the GSM ≤30.5 group (59.5% vs. 41.5%, p = 0.030). Univariate and multivariate analyses identified GSM ≤30.5, ulcerated carotid plaques and pre-operative ischemic symptoms as predictors of post-operative cerebral DWI lesions. Our results indicate that ultrasound-based carotid plaque characteristics help predict new cerebral ischemic lesions after CEA.
本研究旨在确定颈动脉内膜切除术（CEA）后新发脑缺血性病变与颈动脉超声斑块特征之间的关系。2013 年 1 月至 2018 年 12 月，对 1061 例行 CEA 的患者进行了颈动脉双功能超声检查。术前和 CEA 后 30 天内进行了脑磁共振弥散加权成像（DWI）。在 169 例患者中观察到 DWI 上新的脑缺血性病变。用于区分 DWI 阳性和 DWI 阴性患者的灰阶中位数（GSM）截断值为 30.5，受试者工作特征曲线下面积为 0.837。GSM≤30.5 组中观察到更多的多发性 DWI 病变（59.5%比 41.5%，p=0.030）。单因素和多因素分析确定 GSM≤30.5、溃疡性颈动脉斑块和术前缺血症状是术后脑 DWI 病变的预测因素。我们的研究结果表明，基于超声的颈动脉斑块特征有助于预测 CEA 后新发脑缺血性病变。
