Relationship Between Carotid Plaque Stability And Cerebral Infarction Assessed By Contrast-Enhanced Ultrasonography

Objective:Contrast-enhanced ultrasound(CEUS)can observe the enhancement neoangiographyincarotid plaque to evaluate the stability of plaque.To this end,we explored the correlation between plaque stability assessed by CEUS and the occurrence of cerebral infarction.And we also analyzed the correction between the correlation between serumbiomarker levels and the grading of neovascularization enhancement in plaques and its influence on the degree of plaque stability.Methods: 70 patients with acute anterior c-irculation ischemic stroke as the case group and 60 inpatiernts with stroke as the control group in the Department of Neurology of the Affiliated Hospital of Inner Mongolia Medical University from December 2020 to December 2021.General data,including gender,age,and history of underlying diseases,and serum inflammation level,lipids a-nd coagulation level in both groups,and CEUS was performed in those with plaque to determine the stability of the plaque by grading the intraplaque neovascularization u-sing contrast-enhanced grading criteria.The enhanced grading of intraplaque neoangiography was recorded,and its correlation with the occurrence of cerebral infarction was a-nalyzed.The case group was grouped by NIHSS score and CISS typing,and the correlation between plaque enhancement grading and NIHSS score and CISS typing was a-nalyzed.The case group was graded according to the plaque enhancement grading cri-teria and analyzed for correlation with serum biomarkers,and further divided into sta-ble(grade I and II)and unstable(grade III and IV)groups to analyze the biomarkers affecting plaque stability.Results:(1)There was a significant difference in carotid plaque stability between the case group and the control group(P=0.001).(2)The plaque enhancement grading was mainly graded III and IV in the case group,accounting for 54.29%;grades I and II in the control group,acco-unting for 73.33%.There was a significant difference in plaque enhancement grade between the two groups(P<0.05).The incidence of cerebral infarction in plaque enhancement grades I,II,III,and IV was36.84%(14/38),47.37%(18/38),64.44%(29/45),and 90.00%(9/10),respectively,and there was a statistically significant difference in the incidence of cerebral infarction in patients with different enhancement grades of plaque in the case group(P< 0.05).There was a positive correlation between the incidence of cerebral infarction and plaque enhancement grade(r=0.982,P<0.05).(3)Carotid plaque neovascularization enhancement grade was positively correlated with NIHSS score in the case group(r=0.327,P<0.01).(4)CISS classification of case group included carrier artery plaque blockage perforating group,low perfusion removal decreased group,artery-to-artery embolization group,and mixed type group.There were significant statistical differences in plaque enhancement grading among these groups(P<0.05).And 80.65%(25/31)of the patients in the carrier artery plaque blockage through branch group had predominantly grade I and grade II plaque enhancement grading,and 19 cases patients in the artery-to-artery group were all grade III and IV(19/19).(5)We found homocysteine,low-density lipoprotein,lymphocytes,neutrophil/lymphocyte ratio,interleukin-6,and C-reactive protein were the influencing factors of cerebral infarction(P <0.05).Low-density lipoprotein with neutrophils(OR 2.528,95% CI 1.241-5.152,P=0.011 vs OR 1.538,95% CI 1.026-2.304,P=0.037)was a risk factor for plaque vulnerability,and lymphocytes(OR 0.160,95% CI 0.027-0.955,P=0.044)was a protective factor for plaque stability.Homocysteine(r=0.311,P=0.009),LDL(r=0.438,P=0.000),neutrophil/lymphocyte ratio(r=0.438,P=0.000),interleukin-6(r=0.354,P=0.003),and C-reactive protein(r=0.288,P=0.016)levels were positively correlated with plaque susceptibility were positively correlated and lymphocyte(r=-0.460,P=0.000)concentrations were negatively correlated with them.Conclusion:CEUS can effectively assess the stability of carotid plaque,and the higher the degree of plaque vulnerability,the higher the probability of cerebral infarction and the more severe the neurological impairment with a predominant arterial-to-arterial embolism staging.The higher the levels of homocysteine,low-density lipoprotein,neutrophil/lymphocyte ratio,interleukin-6,and C-reactive protein,and the lower the concentration of lymphocytes,the worse the plaque stability.