CEUS In Evaluation On Microvascular Perfusion In Hypertension Patients With Carotid Artery Hypoechoic Plaques In Different Blood Pressure Conditions

ObjectiveTo evaluate the degree of microvascular perfusion in hypertension patients with carotid artery hypoechoic plaques with semi-quantitative and quantitative CEUS under different blood pressure conditions.MethodsTotally 35 hypertension patients with carotid artery hypoechoic plaques were collected,24 h ambulatory blood pressure was monitored to observe the highest and lowest blood pressure within 24 hours,and the differences of plaque enhancement grade and enhancement intensity were compared between the two blood pressure states.Results(1)Semi-quantitative method highest blood groop: 6 cases in grade 1,11 cases in grades 2,9 cases in grade 3,and 9 cases in grade 4;lowest blood group;7 cases in grade 1,11 cases in grades 2,9 cases in grade 3,and 8 cases in grade 4.There was no significant difference between two group under different blood pressure states.(2)Quantitative method Comparing the highest blood pressure group to the lowest blood pressure group,the difference between the enhancement intensity,systolic pressure and diastolic pressure is statistically significant.(3)Correlation analysis Enhancement intensity was positively correlated to SBP,DBP.ConclusionsCEUS semi-quantitative grading method and QLAD quantitative grading software were used to observe the microvascular perfusion of carotid artery plaques with different blood pressure states.At the highest and lowest blood pressure states,the semi-quantitative grading method showed that there was no significant difference between the enhancement grading of hypoechoic plaques in patients with hypertension.It is suggested that under different blood pressure conditions,the semi-quantitative method still has certain limitations in evaluating the amount of neovascularization in carotid artery hypoechoic plaques.In other words,the effect of blood pressure fluctuation will not be recognized by semi-quantitative method,therefore it can’t accurately tell the level of microvascular perfusion in the plaques and may underestimate the severity of the illness.The semi-quantitative grading method for dynamic assessment of plaque vulnerability needs further study.Quantitative analysis is to use QLAD quantitative software to quantitatively analyze the signal intensity in ROI,it can remedy the difference between human individual vision in image discrimination.In this study,it was found that there was a statistically significant difference in EI between the highest and lowest blood pressure states in hypertensive patients,and with the increase in blood pressure,especially in systolic blood pressure,EI in plaques increased significantly,indicating that the impact of blood pressure level on microvascular perfusion in hypoechoic plaques did exist.Therefore,quantitative method is more accurate than semi-quantitative in dynamic evaluation of angiogenesis in arterial plaques.Blood pressure is one of the factors that affect the perfusion status of the plaque.In the dynamic process of evaluation for hypertensive patients with hypoechoic plaques by CEUS,the time of ceus should be reasonably selected,which is of certain clinical significance for individualized evaluation of arterial plaques.