Abstract
Inflammatory activity plays a central role in the development of carotid rupture-vulnerable atherosclerotic plaques, which is one of the major contributors to acute ischemic stroke. Our objective was to characterize carotid intraplaque neovascularizations (INP) using contrast-enhanced ultrasound (CEUS) and evaluate plaque burden through exploring the relationship between INP and cell count of peripheral leukocytes. Sixty-two patients with large artery atherosclerosis (LAA) were enrolled in this study. CEUS was performed to characterize the carotid artery plaques. The correlations between the CEUS imaging features of carotid plaques and leukocyte counts were investigated. The results showed that the characteristic parameters derived from CEUS, including peak of time-intensity curve (TIC-P), mean of time-intensity curve (TIC-M), peak (FC-P), sharpness (FC-S) and area under the curve (FC-AUC) compared with the control group, were all increased in the stroke group. TIC-P, TIC-M and FC-P were negatively related to lymphocytes, respectively. FC-S and FC-AUC were positively correlated with neutrophils, respectively. Our study indicated carotid INP was closely related to the peripheral leukocytes count. CEUS may serve as a useful tool to predict vulnerability of plaque.
Highlights
Stroke is one of the leading causes of mortalities worldwide with 15 million people experiencing a new or recurrent stroke every year, resulting in 5 million deaths and an additional 5 million patients who are permanently disabled
The total cell count of circulating leukocytes and neutrophils in the Acute ischemic stroke (AIS) group were higher than those in the control group, while the number of lymphocytes was smaller than the control group (P < 0.05)
There was statistically significant in the amount of intraplaque neovascularizations (INP) between patients with and without AIS (Table 2)
Summary
Stroke is one of the leading causes of mortalities worldwide with 15 million people experiencing a new or recurrent stroke every year, resulting in 5 million deaths and an additional 5 million patients who are permanently disabled. Increasing evidences point to the process of adventitial vasa vasorum, which in turn contributes to the intraplaque neovascularization, an important feature in plaque development and vulnerability triggered by inflammation and hemorrhage[10,11]. Population-based studies have proven the association between the presence of plaque and total white blood cells and monocytes counts[12,13]. CEUS can evaluate the vulnerability of plaques by quantitatively analyzing the intraplaque neo-angiogenesis and serve as a visualization diagnostic tool for the adventitia vasa vasorum[14]. Few studies have investigated the relationship between the neo-angiogenesis and the circulating leukocytes in acute ischemic stroke patient. The aim of this study was to investigate the plaque vulnerability by quantitatively evaluating the carotid intraplaque neo-angiogenesis using CEUS in AIS patients and analyze the correlation between the cell count of leukocyte subpopulations
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