Carotid artery stiffness measured by strain elastography ultrasound is a stroke risk factor

Abstract

It has been known that carotid stiffness is a predilection for stroke. Strain elastography (SE) ultrasound (US) is one of the new modalities which can evaluate carotid artery stiffness by obtaining its tunica intima media strain value. There were no studies that show the carotid artery SE US value in stroke patients, hence become the underlying reason this study was conducted. The aim of this study was to provide an evaluation of carotid artery SE US values in stroke patients.A pair-matched case-control study was conducted on 40 case subjects and 40 controls which met all inclusion and exclusion criteria. Carotid arteries SE US value was obtained through the average of 3 region of interest (ROI) on each intima media layer of 3 level carotid arteries assessed on both sides. Diagnostic accuracy study was analysed to determine the cut off value between stiff and not stiff. Subsequently, bivariate and multivariate analyses were performed.There were 65% male on both groups with mean age 56.7 ± 13.0 on the case group and 53.8 ± 11.8 on the control group. ROC curve analysis showed that all measurement locations were reliable with high numbers (91.03–97.8%). The cut of value of carotid artery stiffness was ≥0.9333 (97.5% sensitivity and 90% specificity). Carotid artery stiffness is a major risk factor of stroke with OR 351 (p value 0.000). Multivariate analysis showed that carotid artery stiffness remained a strong risk factor of stroke (OR 467.89, p value 0,000). Other radiologist can repeat this technique with good interobserver (r = 0.782–0.985) and intraobserver reliability (r = 0.802–0.954).Carotid artery stiffness is a strong risk factor for stroke, with carotid artery stiffness SE US cut off values of ≥0.9333.