Contrast-enhanced Ultrasound Assessment Of Carotid Plaque Stability And Its Correlation With The Expression Of CD147 And MMP-9 In The Plaque

Objective:To investigate the correlation of contrast-enhanced ultrasound(CEUS)and plaque morphology with the expression of CD147 and MMP-9 in carotid atherosclerotic plaque tissue in patients with carotid endarterectomy,and to evaluate the diagnostic efficacy of contrast-enhanced ultrasound with pathological results as the gold standard Methods:From July 2019 to June 2020,38 patients with carotid artery stenosis underwent carotid endarterectomy.2-D ultrasound was used to determined plaque morphology,characteristic of echo,fiber cap integrity,presence of ulcer,degree of vascular stenosis,The neovascularization and plaque surface morphology were determined by contrast-enhanced ultrasound(CEUS)before operation.After operation,pathological sections and immunohistochemical analysis of CD147 and MMP9 levels were performed in the plaque tissues,and compared with the results of CEUS grading and pathological result.Result:Among the 38 patients,10 cases had stable plaque and 28 cases had vulnerable plaque.The number of smokers in vulnerable plaque group was higher,and CD147 and MMP-9 in plaque were higher.There were statistically significant differences in plaque morphology grading and contrast-enhanced ultrasound grading between the stable plaque group and vulnerable plaque group.There was no significant difference in age,gender,hypertension,diabetes and coronary heart disease between the two groups.CD147 in grade IV group was higher than that in grade I group(P = 0.040)and grade II Group(P = 0.010).The level of MMP-9 in grade IV group was higher than that in grade II Group(P = 0.017),and that in grade III group was higher than that in grade II Group(P = 0.015).There was a positive correlation between Intra-plaque contrast enhancement and CD147(r = 0.462,P = 0.003).There was a positive correlation between Intra-plaque contrast enhancement and MMP-9(r =0.382,P = 0.018).There was moderate consistency between 2D ultrasound and histopathology(kappa = 0.457,P > 0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 85.7%,60.0%,85.7%,60.0% and 78%,respectively.There was a strong consistency between CEUS and histopathology(kappa = 0.671,P < 0.01).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 89.2%,80.0%,92.6%,72.7% and 86.8%,respectively Conclusion:As a real-time,rapid evaluation method of atherosclerosis,contrast-enhanced ultrasound can show the number of new blood vessels in the plaque,which has a good diagnostic value for vulnerable plaque.The expression of CD147 and MMP-9 in vulnerable plaques was increased,and there was a good correlation between CD147,MMP-9 and CEUS.