Zhang Luni, Wu Rong, Chen Jing, Gu Shiyao, Jia Caixia
Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ultrasonography. 2025 Jan;44(1):62-71. doi: 10.14366/usg.24123. Epub 2024 Oct 20.
There is still insufficient evidence for predicting stroke risk in patients with mild carotid atherosclerotic stenosis. This study aimed to explore the association between carotid intraplaque neovascularization (IPN) in mild stenosis and ischemic stroke, using contrast-enhanced ultrasound (CEUS) imaging.
This retrospective observational study included 369 patients from July 2021 to March 2022. These patients were categorized as symptomatic or asymptomatic based on their recent history of ipsilateral ischemic stroke. Initial parameters of carotid plaques, such as IPN grading and contrast enhancement index, were assessed using B-mode ultrasonography and CEUS. The follow-up period lasted 12 months or until a newly-developed ischemic stroke occurred. Logistic regression models and Cox proportional-hazards regression models were employed to explore the associations between ultrasonic parameters and the incidence of recent and future ischemic strokes.
In patients with mild stenosis, both increasing age and grade 2 carotid IPN were significant predictors of recent primary ischemic stroke. Furthermore, grade 2 carotid IPN independently predicted future ischemic strokes in both symptomatic and asymptomatic patients.
This study demonstrated that carotid IPN as detected by CEUS imaging holds potential as a useful non-invasive biomarker for predicting recent and future ischemic strokes in patients with mild carotid stenosis.
对于轻度颈动脉粥样硬化狭窄患者的卒中风险预测，目前仍缺乏足够的证据。本研究旨在利用对比增强超声（CEUS）成像技术，探讨轻度狭窄患者颈动脉斑块内新生血管形成（IPN）与缺血性卒中之间的关联。
这项回顾性观察性研究纳入了2021年7月至2022年3月期间的369例患者。根据同侧缺血性卒中近期病史，将这些患者分为有症状或无症状组。使用B型超声和CEUS评估颈动脉斑块的初始参数，如IPN分级和对比增强指数。随访期持续12个月或直至发生新的缺血性卒中。采用逻辑回归模型和Cox比例风险回归模型，探讨超声参数与近期和未来缺血性卒中发生率之间的关联。
在轻度狭窄患者中，年龄增长和2级颈动脉IPN均是近期原发性缺血性卒中的显著预测因素。此外，2级颈动脉IPN在有症状和无症状患者中均独立预测未来缺血性卒中。
本研究表明，CEUS成像检测到的颈动脉IPN有潜力作为一种有用的非侵入性生物标志物，用于预测轻度颈动脉狭窄患者近期和未来的缺血性卒中。
