The clinical value of carotid contrast-enhanced ultrasound in assessment of intraplaque neovascularization of atherosclerotic plaques

Objective To investigate the value of predicting the vulnerability of atherosclerotic plaques in assessment of intraplaque neovascularization using carotid contrast-enhanced ultrasound. Methods A total of 24 cases diagnosed as moderate to severe carotid stenosis by digital subtraction angiography (DSA) underwent carotid endarterectomy (CEA) from September 2017 to October 2018. Preoperative carotid contrast-enhanced ultrasound and postoperative pathological examination were performed in the patients. Results Compared with postoperative pathological results, 22 cases were clearly diagnosed by preoperative carotid contrast-enhanced ultrasound, and 2 cases were missed. The precision rate of preoperative diagnosis was 91.67% (22/24). Meanwhile carotid plaques were divided into four grades (Grade Ⅰ-Ⅳ) according to the degree of enhancing extent of contrast-enhanced ultrasound. Each grade included 6 cases (25%). Pearson correlation analysis showed there was an evidently positive correlation between preoperative grade of carotid plaques and number of intraplaque CD34-positive neovessels (r = 0.871, P = 0.000). The value of area under the curve (AUC) was 0.927 (95% CI: 0.848-1.006, P = 0.000). Conclusions The grade of carotid plaques was positively related to intraplaque CD34-positive neovessels. Hence, carotid contrast-enhanced ultrasound plays an important role in predicting the vulnerability of atherosclerotic plaques and risk of ischemic stroke and judging optimal surgical time. DOI: 10.3969/j.issn.1672-6731.2019.03.00