Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Clin Transl Sci. 2023 Mar;16(3):502-511. doi: 10.1111/cts.13465. Epub 2023 Jan 5.
Stroke is closely associated with carotid plaques. The assessment of carotid plaque is still the key issue of stroke prevention in clinical practice. This prospective cross-sectional study included patients with carotid plaque evaluated by ultrasonography (US). The intima-media thickness (IMT), lumen stenosis severity, thickness, and length of carotid plaque were measured by the routine US, and the amplitudes of subharmonics in the upstream shoulder, top, and downstream shoulder of all plaques and corresponding lumens were observed by Subharmonic Aided Pressure Estimation (SHAPE) US examination from the US contrast agent perflubutane microbubbles (Sonazoid), which analyzed the clinical parameters of patients, the subharmonic amplitude characteristics of all plaques and lumens, and the parameter differences between the ischemic stroke (IS) group and control group. From May 2021 to February 2022, 46 carotid plaques of 23 patients were included. For plaques, the subharmonic amplitude in the plaque (-60.52 ± 4.46) was lower than that in the opposing level lumen (-56.82 ± 5.68 dB), the subharmonic gradient across the plaque cap was negatively correlated with plaque thickness (r = -0.51, p < 0.001), and with the lumen stenosis severity (r = -0.42, p = 0.003). The median IMT of the IS group was thicker than the control group. The subharmonic gradient of the intraplaque of the IS group was larger than the control group (p = 0.004). In this analysis, we use the receiver operating characteristic (ROC) curve to establish the cutoff value of the difference to predict a new monitoring method for plaque without invasion to predict IS. It still needs a large-scale study with long-term follow-up to validate these findings.
中风与颈动脉斑块密切相关。颈动脉斑块的评估仍然是临床预防中风的关键问题。本前瞻性横断面研究纳入了经超声（US）评估的颈动脉斑块患者。通过常规 US 测量颈动脉斑块的内-中膜厚度（IMT）、管腔狭窄严重程度、厚度和长度，并通过超声造影剂 Perflubutane 微泡（Sonazoid）的次谐波辅助压力估计（SHAPE）US 检查观察所有斑块及其相应管腔的上游肩、顶部和下游肩的次谐波幅度，分析患者的临床参数、所有斑块和管腔的次谐波幅度特征，以及缺血性中风（IS）组和对照组的参数差异。2021 年 5 月至 2022 年 2 月，共纳入 23 例患者的 46 个颈动脉斑块。对于斑块，斑块内的次谐波幅度（-60.52±4.46）低于对侧水平管腔（-56.82±5.68dB），斑块帽上的次谐波梯度与斑块厚度呈负相关（r=-0.51，p<0.001），与管腔狭窄严重程度呈负相关（r=-0.42，p=0.003）。IS 组的平均 IMT 比对照组厚。IS 组斑块内次谐波梯度大于对照组（p=0.004）。在这项分析中，我们使用接收器操作特征（ROC）曲线建立差异的截断值，以建立一种新的无侵袭性斑块监测方法来预测 IS。仍需要一项具有长期随访的大规模研究来验证这些发现。
