Correlation between carotid intraplaque neovascularization and acute ischemic erebrovascular disease: a contrast-enhanced ultrasound study

Abstract

Objective To investigate the correlation between carotid intraplaque neovascularization and acute ischemic cerebrovascular disease. Methods The patients examined with contrast-enhanced ultrasound were enrolled and divided into either a symptomatic group or an asymptomatic group according to their cerebral ischemic symptoms. The patients were also divided into a low-echo group, an equal-echo group, and an heterogeneous echo group according to the plaque echo characteristics on conventional ultrasound. The carotid intraplaque neovascularization was evaluated with contrast-enhanced ultrasound. Multivariate logistic regression analysis was used to identify the correlation between carotid intraplaque neovascularization and acute ischemic cerebrovascular disease. Results A total of 73 patients with acute ischemic cerebrovascular disease were enrolled, 32 patients in the symptoms group (19 ischemic stroke, 13 transient ischemic attack), 41 patients in the asymptomatic group. Plaque echo characteristics: low-echo 15, equal-echo 41, and heterogeneous echo 17. The proportions of the patients with plaque enhancement (84.4% vs. 61.0%; χ2=4.802, P=0.028) and enhanced intensity (21.78±8.50 dB vs. 15.93±8.82 dB; t=2.440, P=0.018) in the symptomatic group were significantly higher than those in the asymptomatic group. The proportions of the patients with enhanced plaque in the low-echo, equal-echo and heterogeneous echo group were 93.3%, 58.5%, and 82.4%, respectively (χ2=7.826, P=0.020). The low-echo group and heterogeneous echo group were significantly higher than the equal-echo group (all P 0.05). The intraplaque enhanced intensities in the low-echo group, equal-echo group, and heterogeneous echo group were 22.62±9.33 dB, 14.38±8.02 dB, and 18.15±9.64 dB, respectively (F=3.877, P=0.027). The low-echo group was significantly higher than the equal-echo group (P=0.024). Multivariate logistic regression analysis showed that carotid intraplaque neovascularization (odds ratio 3.456, 95% confidence interval 1.103-10.828; P=0.033) was independently associated with acute ischemic cerebrovascular disease. Conclusions Carotid intraplaque neovascularization is closely associated with acute ischemic cerebrovascular disease. Key words: Carotid Artery Diseases; Stroke; Brain Ischemia; Neovascularization, Pathologic; Ultrasonography; Contrast Media