Study On Evaluation Of The Effect Of Wendan Capsules On Neovascularization In The Carotid Atherosclerotic Vulnerable Plaques By Contrast-enhanced Ultrasonography

ObjectiveTo analyze the characteristics of the enhancement of carotid atherosclerotic vulnerable plaques with contrast-enhanced ultrasonography(CEUS). And to investigate the effect of Wendan capsule treatment on neovascularization with the vulnerable carotid atherosclerotic plaques using CEUS.Methods1. Forty patients(40 plaques total) which were according to the inclusion criteria with soft carotid atherosclerotic plaques were randomly divided into two groups:treatment group(22 patients) and control group(18 patients). Treatment of basic diseases in all the patients were obtained before and after the Wendan capsule treatment. Then a dose(4 tablets each time,3 times every day) of Wendan capsules was given to the treatment group for three months, and the control group without lipid-lowering treatment.2. Each patient was examined before and after three-months'treatment respectively using routine ultrasound and serology to measure the carotid intima-media thickness (IMT), plaque thickness, plaque area, LDL and TG. CEUS was used to observe the imaging performance of the carotid plaques, and the based intensity(BI), peak intensity(PI), intensity of enhancement (IE), density of enhancement (DE). 3. The variables of routine ultrasound, CEUS, and the serum markers of two groups were compared.Results1.The diffusing direction of contrast agent on the plaques:52.5%(21/40) of all the plaques were enhanced from external intimal layers toward the inside of the plaque,32.5%(13/40) were enhanced from both the external intimal layers and carotid cavity toward the inside of the plaque,15%(6/40) were enhanced from the carotid cavity toward the inside of the plaque.2.The diffusing appearance of contrast agent on the plaques:spot and/or short-line pattern. 3. The distribution of contrast agent visualization on the plaques:â‘ All plaques presented stronger enhancement on the periphery of plaques than the center of plaques;â‘¡42.5%(17/40) of all the plaques presented stronger enhancement on the head section of the plaques, and 35%(14/40) on the tail section,22.5%(9/40) on the body section;â‘¢82.5%(33/40) of all the plaques presented stronger enhancement on the base of the plaques, and 17.5%(7/40) on the fibrous cap.4. After three-months'treatment, the carotid IMT, plaque thickness, plaque area in treatment group were decreased compared with both pre-therapy and those in control group(P<0. 05); EI and DE of carotid plaques in treatment group were decreased significantly than both pre-therapy and those in control group(P<0. 05); Levels of LDL and TG were also decreased obviously compared with those in control group(P<0. 05). While the difference of the corresponding indicators above in control group has no significance between pre-therapy and post-treatment (P>0. 05).Conclusion1.CEUS provides a sensitive way to observe the enhancement and demonstrate the hemodynamic of neovascularization of carotid vulnerable plaques. At the same time, CEUS shows to be effective in quantitatively assessing the degree of neovascularization with the carotid atherosclerotic plaques. It thus conduce to assess the vulnerability of carotid atherosclerotic plaques.2. The Wendan capsule treatment for Phlegm Syndrome carotid atherosclerotic patients shows to be effective in reducing neovascularization within the plaques. 3. CEUS can be used to evaluate the effect of treatment of carotid vulnerable plaques.