Department of Ultrasound, Yantaishan Hospital, Yantai, China.
Department of Imaging Division, Yantaishan Hospital, Yantai, China.
PeerJ. 2023 Sep 27;11:e16150. doi: 10.7717/peerj.16150. eCollection 2023.
This study aimed to compare the efficiency of evaluating carotid plaque stability using ultrasonic shear wave elastography (SWE), AngioPLUS planewave ultrasensitive imaging (AP), and optimized high-resolution magnetic resonance imaging (MRI).
A total of 100 patients who underwent carotid endarterectomy at our hospital from October 2019 to August 2022 were enrolled. Based on the final clinical diagnosis, these patients were divided into vulnerable ( = 62) and stable ( = 38) plaque groups. All patients were examined using ultrasound SWE, AP, and optimized high-resolution MRI before surgery. The clinical data and ultrasound characteristics of patients of the two groups were compared. Considering the final clinical diagnosis as the gold standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE, AP, high-resolution MRI, and the final clinical diagnosis of vulnerable plaque were calculated. Pearson's correlation test was used to analyze the correlations of AP, SWE, and MRI results with the grading results of carotid artery stenosis.
Statistically significant differences were noticed in terms of the history of smoking and coronary heart disease, plaque thickness, surface rules, calcified nodules, low echo area, and the degree of carotid artery stenosis between the two groups ( < 0.05). Considering the final clinical diagnosis as the gold standard, the sensitivity, specificity, PPV, and NPV of SWE-based detection of carotid artery vulnerability were 87.10% (54/62), 76.32% (29/38), 85.71% (54/63) and 78.38% (29/37), respectively, showing a general consistency with the final clinical results (Kappa = 0.637, < 0.05). Considering the final clinical diagnosis as the gold standard, the sensitivity, specificity, PPV and NPV of AP-based detection of carotid artery vulnerability were 93.55% (58/62), 84.21% (32/38), 90.63% (58/64), and 88.89% (32/36), respectively, which agreed with the final clinical detection results (Kappa = 0.786, < 0.05). Considering the final clinical diagnosis as the gold standard, the sensitivity, specificity, PPV and NPV of high-resolution MRI-based detection of carotid artery vulnerability were 88.71% (55/62), 78.95% (30/38), 87.30% (55/63), and 81.08% (30/37), respectively, showing consistency with the final clinical results (Kappa = 0.680, < 0.05). AP, SWE, and MRI results were positively correlated with the results of carotid artery stenosis grading ( < 0.05).
AP technology is a non-invasive, inexpensive, and highly sensitive method to evaluate the stability of carotid artery plaques. This method can dynamically display the flow of blood in new vessels of plaque in real time and provide a reference for clinical diagnosis and treatment.
本研究旨在比较超声剪切波弹性成像（SWE）、AngioPLUS 平面波超敏感成像（AP）和优化高分辨率磁共振成像（MRI）评估颈动脉斑块稳定性的效率。
选取 2019 年 10 月至 2022 年 8 月在我院行颈动脉内膜切除术的 100 例患者，根据最终临床诊断将这些患者分为易损斑块（n=62）和稳定斑块（n=38）组。所有患者均在术前接受超声 SWE、AP 和优化高分辨率 MRI 检查。比较两组患者的临床资料和超声特征。以最终临床诊断为金标准，计算 SWE、AP、高分辨率 MRI 及易损斑块最终临床诊断的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。采用 Pearson 相关检验分析 AP、SWE 和 MRI 结果与颈动脉狭窄分级结果的相关性。
两组患者在吸烟史、冠心病史、斑块厚度、表面规则性、钙化结节、低回声区、颈动脉狭窄程度等方面的差异有统计学意义（P<0.05）。以最终临床诊断为金标准，SWE 检测颈动脉易损斑块的敏感性、特异性、PPV 和 NPV 分别为 87.10%（54/62）、76.32%（29/38）、85.71%（54/63）和 78.38%（29/37），与最终临床结果具有较好的一致性（Kappa=0.637，P<0.05）。以最终临床诊断为金标准，AP 检测颈动脉易损斑块的敏感性、特异性、PPV 和 NPV 分别为 93.55%（58/62）、84.21%（32/38）、90.63%（58/64）和 88.89%（32/36），与最终临床检测结果一致（Kappa=0.786，P<0.05）。以最终临床诊断为金标准，高分辨率 MRI 检测颈动脉易损斑块的敏感性、特异性、PPV 和 NPV 分别为 88.71%（55/62）、78.95%（30/38）、87.30%（55/63）和 81.08%（30/37），与最终临床结果具有一致性（Kappa=0.680，P<0.05）。AP、SWE 和 MRI 结果与颈动脉狭窄分级结果呈正相关（P<0.05）。
AP 技术是一种非侵入性、价格低廉、高度敏感的评估颈动脉斑块稳定性的方法。该方法可以实时动态显示斑块内新生血管的血流情况，为临床诊断和治疗提供参考。
