Cargando…

Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque

OBJECTIVE: Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine wh...

Descripción completa

Detalles Bibliográficos
Autores principales: Huang, Zhe, Cheng, Xue-Qing, Liu, Ya-Ni, Bi, Xiao-Jun, Deng, You-Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Radiology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067694/
https://www.ncbi.nlm.nih.gov/pubmed/36907591
http://dx.doi.org/10.3348/kjr.2022.0977
_version_ 1785018530289156096
author Huang, Zhe
Cheng, Xue-Qing
Liu, Ya-Ni
Bi, Xiao-Jun
Deng, You-Bin
author_facet Huang, Zhe
Cheng, Xue-Qing
Liu, Ya-Ni
Bi, Xiao-Jun
Deng, You-Bin
author_sort Huang, Zhe
collection PubMed
description OBJECTIVE: Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine whether plaque enhancement can contribute to risk assessment for recurrent stroke compared with the Essen Stroke Risk Score (ESRS). MATERIALS AND METHODS: This prospective study screened 151 patients with recent ischemic stroke and carotid atherosclerotic plaques at our hospital between August 2020 and December 2020. A total of 149 eligible patients underwent carotid CEUS, and 130 patients who were followed up for 15–27 months or until stroke recurrence were analyzed. Plaque enhancement on CEUS was investigated as a possible risk factor for stroke recurrence and as a possible adjunct to ESRS. RESULTS: During follow-up, 25 patients (19.2%) experienced recurrent stroke. Patients with plaque enhancement on CEUS had an increased risk of stroke recurrence events (22/73, 30.1%) compared to those without plaque enhancement (3/57, 5.3%), with an adjusted hazard ratio (HR) of 38.264 (95% confidence interval [CI]:14.975–97.767; P < 0.001) according to a multivariable Cox proportional hazards model analysis, indicating that the presence of carotid plaque enhancement was a significant independent predictor of recurrent stroke. When plaque enhancement was added to the ESRS, the HR for stroke recurrence in the high-risk group compared to that in the low-risk group (2.188; 95% CI, 0.025–3.388) was greater than that of the ESRS alone (1.706; 95% CI, 0.810–9.014). A net of 32.0% of the recurrence group was reclassified upward appropriately by the addition of plaque enhancement to the ESRS. CONCLUSION: Carotid plaque enhancement was a significant and independent predictor of stroke recurrence in patients with ischemic stroke. Furthermore, the addition of plaque enhancement improved the risk stratification capability of the ESRS.
format Online
Article
Text
id pubmed-10067694
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher The Korean Society of Radiology
record_format MEDLINE/PubMed
spelling pubmed-100676942023-04-04 Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque Huang, Zhe Cheng, Xue-Qing Liu, Ya-Ni Bi, Xiao-Jun Deng, You-Bin Korean J Radiol Neurointervention OBJECTIVE: Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine whether plaque enhancement can contribute to risk assessment for recurrent stroke compared with the Essen Stroke Risk Score (ESRS). MATERIALS AND METHODS: This prospective study screened 151 patients with recent ischemic stroke and carotid atherosclerotic plaques at our hospital between August 2020 and December 2020. A total of 149 eligible patients underwent carotid CEUS, and 130 patients who were followed up for 15–27 months or until stroke recurrence were analyzed. Plaque enhancement on CEUS was investigated as a possible risk factor for stroke recurrence and as a possible adjunct to ESRS. RESULTS: During follow-up, 25 patients (19.2%) experienced recurrent stroke. Patients with plaque enhancement on CEUS had an increased risk of stroke recurrence events (22/73, 30.1%) compared to those without plaque enhancement (3/57, 5.3%), with an adjusted hazard ratio (HR) of 38.264 (95% confidence interval [CI]:14.975–97.767; P < 0.001) according to a multivariable Cox proportional hazards model analysis, indicating that the presence of carotid plaque enhancement was a significant independent predictor of recurrent stroke. When plaque enhancement was added to the ESRS, the HR for stroke recurrence in the high-risk group compared to that in the low-risk group (2.188; 95% CI, 0.025–3.388) was greater than that of the ESRS alone (1.706; 95% CI, 0.810–9.014). A net of 32.0% of the recurrence group was reclassified upward appropriately by the addition of plaque enhancement to the ESRS. CONCLUSION: Carotid plaque enhancement was a significant and independent predictor of stroke recurrence in patients with ischemic stroke. Furthermore, the addition of plaque enhancement improved the risk stratification capability of the ESRS. The Korean Society of Radiology 2023-04 2023-02-16 /pmc/articles/PMC10067694/ /pubmed/36907591 http://dx.doi.org/10.3348/kjr.2022.0977 Text en Copyright © 2023 The Korean Society of Radiology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Neurointervention
Huang, Zhe
Cheng, Xue-Qing
Liu, Ya-Ni
Bi, Xiao-Jun
Deng, You-Bin
Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque
title Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque
title_full Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque
title_fullStr Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque
title_full_unstemmed Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque
title_short Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque
title_sort value of intraplaque neovascularization on contrast-enhanced ultrasonography in predicting ischemic stroke recurrence in patients with carotid atherosclerotic plaque
topic Neurointervention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067694/
https://www.ncbi.nlm.nih.gov/pubmed/36907591
http://dx.doi.org/10.3348/kjr.2022.0977
work_keys_str_mv AT huangzhe valueofintraplaqueneovascularizationoncontrastenhancedultrasonographyinpredictingischemicstrokerecurrenceinpatientswithcarotidatheroscleroticplaque
AT chengxueqing valueofintraplaqueneovascularizationoncontrastenhancedultrasonographyinpredictingischemicstrokerecurrenceinpatientswithcarotidatheroscleroticplaque
AT liuyani valueofintraplaqueneovascularizationoncontrastenhancedultrasonographyinpredictingischemicstrokerecurrenceinpatientswithcarotidatheroscleroticplaque
AT bixiaojun valueofintraplaqueneovascularizationoncontrastenhancedultrasonographyinpredictingischemicstrokerecurrenceinpatientswithcarotidatheroscleroticplaque
AT dengyoubin valueofintraplaqueneovascularizationoncontrastenhancedultrasonographyinpredictingischemicstrokerecurrenceinpatientswithcarotidatheroscleroticplaque