Key result
Contrast-enhanced ultrasound peak intensity and 2-D strain parameters were positively correlated with microvascular density and VEGF expression in unstable carotid plaques (p < 0.05).
Why the study?
The study aimed to explore the value of contrast-enhanced ultrasound combined with 2-D strain imaging in evaluating carotid plaque vulnerability and correlations with histopathological findings.
Does contrast-enhanced ultrasound combined with 2-D strain imaging correlate with histopathological markers of carotid plaque vulnerability in patients with carotid artery stenosis?
Cross-Sectional (n=27)
No
Does contrast-enhanced ultrasound combined with 2-D strain imaging correlate with histopathological markers of carotid plaque vulnerability in patients with carotid artery stenosis?
p-value: p=<0.05
CEUS combined with 2-D strain imaging correlates with histopathological markers of neovascularization and mechanical stress, offering a potential non-invasive method to assess carotid plaque vulnerability.
May support non-invasive carotid plaque assessment; leaves open prospective validation before clinical adoption.
OBJECTIVE: The aim of this study was to explore the value of contrast-enhanced ultrasound (CEUS) combined with 2-D strain imaging in evaluating carotid plaque vulnerability and the correlations among CEUS perfusion parameters, strain parameters and histopathological findings in different plaque segments. METHODS: Patients with carotid artery stenosis who underwent carotid endarterectomy (CEA) at the First Affiliated Hospital of Xinjiang Medical University from September 2020 to June 2021 underwent preoperative carotid artery 2-D ultrasonography and CEUS. The plaques were divided into three segments: the proximal end of the shoulder, central cap and distal end of the shoulder. The peak intensity (PI) value and strain rate parameters of the regions of interest were analyzed. Plaques were divided into a stable group (8 cases) and an unstable group (19 cases). The microvascular density (MVD) and vascular endothelial growth factor (VEGF) expression of each patch in the unstable group were analyzed. RESULTS: The peak strain during the systolic period in each plaque segment in both groups showed the following pattern: proximal end shoulder > distal end shoulder > top (p < 0.05). The PI value for CEUS is also represented. In the unstable group, the PI values of each segment of the plaque were positively correlated with the MVD, near-center PI value and VEGF average optical density value. The average optical density of each segment was positively correlated with the MVD (p < 0.05). There were positive correlations between the PI values of the proximal and distal shoulder and the strain values (p < 0.05), and the MVD value of each segment, VEGF value and strain value were positively correlated (p < 0.05). CONCLUSION: PI and the pathological tissue components represented by CEUS were positively correlated with the mechanical parameters of the plaque along the long axis. There may be overlap between the high shear stress area of the plaque and the neovascular aggregation area, and the combination of the two has certain significance for assessing the vulnerability of the plaque.
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Ma et al. (2023) conducted a cross-sectional in Carotid artery stenosis (n=27). Contrast-enhanced ultrasound (CEUS) combined with 2-D strain imaging vs. Stable vs unstable plaques was evaluated on Correlation among CEUS perfusion parameters, strain parameters, and histopathological findings (MVD and VEGF) (p=<0.05). Contrast-enhanced ultrasound peak intensity and 2-D strain parameters were positively correlated with microvascular density and VEGF expression in unstable carotid plaques (p < 0.05).
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