Clinical Study Of Carotid Contrast—enhanced Ultrasonography In Evaluation Of Carotid Atherosclerotic Plaque

Objective:1.In case the high-resolution magnetic resonance imaging is used as gold standard,to evaluate clinical value of carotid contrast—enhancedultrasonographyon stability ofatherosclerotic plaque.2.To explore correlation between basalblood lipid and the stability of atherosclerotic plaque.Methods:1.Collect data from 26 patients who were in hospital for carotid atherosclerotic plaque and they had 67 atherosclerotic plaques in all.Based on the conventional diagnosis of carotid artery ultrasound,all patients were diagnosed to have carotid atherosclerotic plaque.And then,based on carotid contrast—enhanced ultrasonography of carotid artery and high-resolution magnetic resonance imaging of carotid artery,parameters of all inspection equipment are set to be the same so as to analyze sensitivity,specificity and consistency and other indicators of stability of atherosclerotic plaque in conventional ultrasound and carotid contrast—enhanced ultrasonography and then compare their ROC curves;2.Collect data from 24 patients who were in hospital for carotid atherosclerotic plaque and they had 54 atherosclerotic plaques in all.Based on the conventional diagnosis of carotid artery ultrasound,all patients were diagnosed to havecarotidatheroscleroticplaque.Andthen,basedoncarotid contrast—enhancedultrasonography of carotid artery,parameters settings of all inspectioninstrumentsarethesame.Andthen,basallow-density lipoprotein,high-density lipoprotein,triglyceride and total cholesterol level of patients are measured to analyze the correlation between grading of carotid contrast—enhancedultrasonography for atherosclerotic plaque and blood lipid.Results:1.In case the high-resolution magnetic resonance imaging is used as gold standard,the values of sensitivity,specificity,agreement rate,Youden's index,positive likelihood ratio,negative likelihood ratio Kappa value in conventional ultrasound are respectively85.4%?52.6%?76.1%?38.0%?1.80?0.28 and 0.392;their values in carotid contrast—enhanced ultrasonography are respectively 83.3%?89.5%?85.1%?72.8%?7.92?0.19 and 0.650.The area under ROC curve in carotid contrast—enhanced ultrasonography is 0.869 and the best cutoff point is grade 2;The area under ROC curve in conventional ultrasound is 0.647 and the best cutoff point is the mixed echo.There is difference in area under two ROC curves(u=2.29>u_0.05/2=1.96,P<0.05).There is significant correlation between the type of ultrasonic echo and carotid contrast—enhanced ultrasonography.?P=<0.001,Spearman's rank correlation coefficient r=-0.507?;2.carotid contrast—enhanced ultrasonography leveling for 54carotid atherosclerotic plaques:4 at level 0;8 at level 1;12 at level 2;18 at level 3;12at level 4.As for 22 patients with low-density lipoprotein of 2.78±0.47mmol/L,high-density lipoprotein of1.12±0.23 mmol/L,triglyceride of 1.75±0.93 mmol/L,total cholesterol 4.82±0.61 mmol/L.There is significant correlation between the basal low-density lipoprotein and carotid contrast—enhanced ultrasonography grading?P<0.001,Spearman's rank correlation coefficientr=0.520?.There is significant correlation between the basalhigh-density lipoprotein and carotid contrast—enhanced ultrasonographygrading?P=0.009<0.05,Spearman'srankcorrelation coefficientr=-0.353?.There is significant correlation between the basaltotal cholesteroland carotid contrast—enhanced ultrasonography grading?P=0.034<0.005,Spearman's rank correlation coefficientr=0.289?.And there is no correlation between the basaltriglyceride and carotid contrast—enhanced ultrasonography gradingConclusion:1.Carotid contrast—enhancedultrasonography is better than conventional ultrasound on evaluatingthe stability of atherosclerotic plaque,and it can be carried out for further evaluation of stability in carotid atherosclerotic plaque.2.The atherosclerotic plaques with low echo,equal echo and mixed echo can be enhanced more easily,and the atherosclerotic plaques with high echo orstrong echo are difficult to enhance.3.The higher the basal low-density lipoprotein or the total cholesterol is,the poorer the stability of atherosclerotic plaque is.The lower the basal high-density lipoprotein is,the poorer the stability of atherosclerotic plaque is.