Application Of ARFI Technique In Evaluation Of Carotid Plaque In Patients With Cerebral Infarction

The mortality, morbidity of cerebral infarction is high, yet which is the highest national mortality of cerebrovascular disease rate in the world is China.Carotid atherosclerosis is a major cause of cerebral thrombosis,especially the vulnerable atherosclerotic plaque of carotid artery plays an important role in the development of ischemic stroke events. Not only directly affects the prognosis of patients, and prolongs hospitalization time, effects of quality of life,has high disability, high mortality rate, early screening of prognostic risk factors is the key link of clinical treatment and prevention. The clinical risk lies not only in the stenosis caused by atheromatous plaque occupying carotid artery lumen. More important is the internal reconstruction of plaque instability, resulting in plaque rupture, fall off, embolus formation. There is important significance to judge the stability of plaque to prevent cerebral infarction for guiding clinical medication. Doppler ultrasound can observe the size, shape, echo plaque etc. Of course, this according to the classification of plaque plaque acoustic features must have subjective visual.Different examiners to classify the same plaque come to different conclusions, probably due to instrument ultrasound equipment, regulation and clinical experience. The ARFI as a new technology of the elasticity imaging, tissue elasticity evaluation can be quantitative, more objective, This study collected 108 cases of ischemic stroke, 97 cases of non cardiovascular patients hospitalized in the same period, Determination of shear wave velocity of various types of plaque in the application of ARFI Technology(SWV), Discussion on the evaluation of carotid plaque stability of the feasibility and application value, Combined with conventional ultrasound, To study the relationship between stability of carotid plaque and ischemic stroke, and analysis of risk factors of plaque formation.Objective:The application of acoustic radiation force pulse based on two dimensional and color Doppler imaging(ARFI) on the shear velocity measurement technology of various types of plaque, differences so as to evaluate different echo plaque stability, study on the correlation between the stability of plaque and cerebral infarction, and to analyze the risk factors of plaque formation.Methods :We selected 108 cases of patients with cerebral infarction, male 71 cases female 37 cases, age 29-81 years old(average 58.86 ±10.32 years), 97 cases of cerebrovascular patients, including 42 cases of male and 55 cases female, age 25-78 years old(average 56.55 ±7.99 years), the difference between the two groups in age, sex ratio was not statistically significance(P>0.05). Intima media thickness(IMT) >1.0mm is thickening, Intima media thickness localized thickening) >1.5mm, and protruding into the lumen, there is scope clearly judged as plaque formation. According to the echo plaques were divided into low echo plaques(LE), esual echo plaque(EE), mixed echo of plaque(ME), dese echo of plaque(DE), respectively by ARFI technical inspection of all the patches,the average value of each group was compared to the shear wave velocity,use the shear wave velocity size to analysis of stability of various types echo plaque. The experimental group and the control group of plaque detection rate by chi square test, compare differences between the experimental group and control group in plaque type distribution,Evaluate differences between the two groups by rank sum test patch intensity. Records of patients age, smoking status, and the detection of the patient’s blood pressure, blood glucose, high sensitive C- reactive protein, homocysteine, Regression analysis of risk factors of carotid atherosclerotic plaque by Logisitic.Results:205 people were detected in the 188 patches, where low echo plaques in 81(43.09%), mixed echo plaques in 48(25.53%), such as echo plaques in 45(23.93%), the strong echo of plaque in 14(7.44%),Application of variance analysis of shear wave velocity(SWV) were statistically significant mean differences(P<0.05), The strong echo of plaque(4.71± 0.39m/s) > equal echo plaques(2.92±0.56m/s) > mixed echo plaques(2.42±0.71m/s) > low echo plaques(1.42±0.51m/s),To illustrate the strong echo of plaque hardness > equal echo plaque > mixed echo plaques > low echo plaques. Using the chi square test was, two groups of plaque rate were statistically significant(2=44.83, P < 0.001), the observation group of plaque rate(69.4%)higer than the control group(29.3%), the rate of plaque was statistically significant difference between the two groups of plaque composition distribution(2=25.336, P<0.001), rank sum test and application of ordinal variables that, there was statistically significant difference between the two groups in the strength of plaque(P=0.028), the observation group rank lower than that of control group, shows that the plaque of observation group more unstable than in the control group. Single factor variance analysis shows that gender, age, smoking, hypertension, diabetes mellitus, homocysteine, high sensitivity C reactive protein has influence on the formation of plaque(P<0.05). These factors make the Logisitic regression analysis, sex P maximum, P=0.386, no statistical significance, remove it and then do a Logisitic regression analysis, smoking Wals values increased, P values were significantly smaller, that is closely related to smoking and sex, and age, smoking, high blood pressure, diabetes, homocysteine, high sensitivity C reactive protein on plaque formation has an effect(P<0.05).Conclusions:ARFI technique is used to test different echo plaques of shear wave velocity mean different, therefore the ARFI technology can assess the stability of atherosclerotic plaque stability, strong echo plaques over echo plaques than mixed echo plaques than low echo plaques; Atherosclerotic plaques were independent risk factors of ischemic cerebral stroke, especially in unstable plaques more prone to cerebral infarction; The older, more smoking, hypertension, diabetes mellitus, homocysteine and high sensitive C- reactive protein are higher, the greater the possibility of the formation of atherosclerotic plaque.