The Journal of Practical Medicine >

2024 , Vol. 40 >Issue 22: 3232 - 3237

DOI: https://doi.org/10.3969/j.issn.1006-5725.2024.22.019

Medical Examination and Clinical Diagnosis

The relationship between internal carotid artery wall shear stress and carotid plaque neovascularization was evaluated by carotid color ultrasound

  • Yuncan WANG ,
  • Guangyun CAO ,
  • Haibo WU ,
  • Na WANG
Expand
  • Department of Ultrasound，the First Hospital of Hebei Medical University，Shijiazhuang 050057，Hebei，China

Received date: 2024-04-02

  Online published: 2024-11-25

Fold

Abstract

Objective To assess the correlation between wall shear stress （WSS） in the internal carotid artery and neovascularization of carotid plaque using color ultrasound imaging. Methods A total of 99 patients diagnosed with carotid atherosclerotic plaque （CAP） were prospectively selected between July 2021 and September 2023. All patients underwent comprehensive carotid imaging including color ultrasound， conventional ultrasound， and carotid contrast-enhanced ultrasound （CEUS）. Based on the presence or absence of intraplaque neovascularization （IPN） in patients with ischemic cerebrovascular disease， they were categorized into the forming group and non-forming group. Comparative analysis was performed on wall shear stress （WSS） values and clinical data between these two groups to identify factors influencing IPN formation in the carotid artery among patients with ischemic cerebrovascular disease， while also assessing the predictive value of average WSS for IPN formation. Results Among 99 patients with ischemic cerebrovascular disease， carotid artery IPN was observed in 23 cases， while the remaining 76 cases did not exhibit carotid artery IPN. The formation group demonstrated significantly higher levels of white blood cell count， plaque thickness， plaque length， stenosis ≥ 70% ratio， C?reactive protein， and matrix metalloproteinase?9 to tissue inhibitor of matrix metalloproteinase?1 （MMP?9/TIMP?1） ratio compared to the non?formation group （P < 0.05）. Logistic regression analysis revealed that mean wall shear stress （OR = 4.545； 95% CI： 1.998 ~ 10.339）， stenosis severity （OR = 2.765； 95% CI： 1.215 ~ 6.290）， C?reactive protein levels （OR = 3.047； 95% CI： 1.339 ~ 6.930）， and MMP?9/TIMP?1 ratio （OR = 3.543； 95% CI： 1.558 ~ 8.060） were significant influencing factors for carotid artery IPN formation in patients with ischemic cerebrovascular disease （P < 0.05）. The receiver operating characteristic curve （ROC） analysis revealed that the area under the curve （AUC） for average WSS in predicting carotid artery intraplaque neovascularization formation in patients with ischemic cerebrovascular disease was 0.797 （P < 0.05）. At an average WSS of 10.23 dyne/cm2， the maximum specificity and sensitivity were determined to be 85.53% and 78.26%， respectively. Conclusion The mean WSS of internal carotid artery has a good value in predicting the formation of carotid IPN in patients with ischemic cerebrovascular disease.

Key words： carotid contrast-enhanced ultrasound; internal carotid artery wall shear stress; carotid artery intra plaque neovascularization; influencing factors; predictive value

Cite this article

Yuncan WANG , Guangyun CAO , Haibo WU , Na WANG . The relationship between internal carotid artery wall shear stress and carotid plaque neovascularization was evaluated by carotid color ultrasound[J]. The Journal of Practical Medicine, 2024 , 40(22) : 3232 -3237 . DOI: 10.3969/j.issn.1006-5725.2024.22.019

References

1 SUZUKI H， KANAMARU H， KAWAKITA F， et al. Cerebrovascular pathophysiology of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage［J］. Histol Histopathol， 2021，36（2）：143-158.
2 JUNG JW， BAIK M， JEONG J， et al.Prognosis of ischemic stroke patients with both aortic atheroma and cardioembolic sources［J］. Sci Rep， 2024，14（1）：12656. doi:10.1038/s41598-024-60294-1
3 ZHANG L， LI X， LYU Q， et al. Imaging diagnosis and research progress of carotid plaque vulnerability［J］. J Clin Ultrasound， 2022，50（7）：905-912. doi:10.1002/jcu.23266
4 HUANG R， DEMARCO J K， OTA H， et al. Prognostic value of intraplaque neovascularization detected by carotid contrast-enhanced ultrasound in patients undergoing stress echocardiography［J］. J Am Soc Echocardiogr， 2021，34（6）：614-624. doi:10.1016/j.echo.2020.12.016
5 WARBOYS C M， WEINBERG P D. S1P in the development of atherosclerosis： Roles of hemodynamic wall shear stress and endothelial permeability［J］. Tissue Barriers， 2021，9（4）：1959243. doi:10.1080/21688370.2021.1959243
6 李会霞，卢学峰，李伟，等. 颈动脉斑块造影评价新生血管与缺血性脑卒中的关系［J］. 中国实用神经疾病杂志，2022，25（7）：863-867.
7 SONG Y， DANG Y， WANG J， et al. Carotid intraplaque neovascularization predicts ischemic stroke recurrence in patients with carotid atherosclerosis［J］. Gerontology， 2021，67（2）：144-151. doi:10.1159/000511360
8 中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组，中华医学会神经病学分会神经血管介入协作组. 中国缺血性脑血管病血管内介入诊疗指南2015［J］. 中华神经科杂志，2015，48（10）：830-837.
9 国家卫生计生委脑卒中防治工程委员会. 中国脑卒中血管超声检查指导规范［J］. 中华医学超声杂志（电子版），2015，12（8）：599-610.
10 李朝军，杨青，白云，等. 颈动脉斑块超声造影及其定量参数与血压的相关性研究［J］. 临床超声医学杂志，2018，20（8）：522-525.
11 RAFAILIDIS V， CHRYSSOGONIDIS I， XERRAS C， et al. A comparative study of color Doppler imaging and contrast-enhanced ultrasound for the detection of ulceration in patients with carotid atherosclerotic disease［J］. Eur Radiol， 2019，29（4）：2137-2145. doi:10.1007/s00330-018-5773-8
12 LI Y， ZHENG S， ZHANG J， et al. Advance ultrasound techniques for the assessment of plaque vulnerability in symptomatic and asymptomatic carotid stenosis： A multimodal ultrasound study［J］. Cardiovasc Diagn Ther， 2021，11（1）：28-38. doi:10.21037/cdt-20-876
13 BOSWELL-PATTERSON C A， HETU M F， KEARNEY A， et al. Vascularized carotid atherosclerotic plaque models for the validation of novel methods of quantifying intraplaque neovascularization［J］. J Am Soc Echocardiogr， 2021，34（11）：1184-1194. doi:10.1016/j.echo.2021.06.003
14 李硕，高俊华，梁博，等. MRI血管造影对颈动脉狭窄程度和斑块组成成分的检测效果［J］. 影像科学与光化学，2021，39（4）：615-619.
15 SULTAN S R， BASHMAIL F T， ALZAHRANI N A， et al. Contrast-enhanced ultrasound for the evaluation of symptomatic and asymptomatic carotid plaques： a systematic review and meta-analysis［J］. Echocardiography， 2022，39（8）：1032-1043. doi:10.1111/echo.15407
16 李景植，华扬，刘然，等. 超声造影检测颈动脉斑块内新生血管与症状性缺血性脑血管病的相关性研究［J］. 中国脑血管病杂志，2023，20（2）：90-95.
17 刘萌，王晓曦，王亚珍，等. SMI检测颈动脉斑块内新生血管形成及相关危险因素研究［J］. 河北医科大学学报，2019，40（6）：719-723.
18 ANDELOVIC K， WINTER P， KAMPF T， et al. 2D projection maps of WSS and OSI reveal distinct spatiotemporal changes in hemodynamics in the murine aorta during ageing and atherosclerosis［J］. Biomedicines， 2021，9（12）：1856. doi:10.3390/biomedicines9121856
19 MA Y S， XIE Y H， MA D， et al. Shear stress-induced MMP1 and PDE2A expressions in coronary atherosclerosis［J］. Bratisl Lek Listy， 2021，122（4）：287-292. doi:10.4149/bll_2021_048
20 MAZZI V， DE NISCO G， HOOGENDOORN A， et al. Early atherosclerotic changes in coronary arteries are associated with endothelium shear stress contraction/expansion variability［J］. Ann Biomed Eng， 2021，49（9）：2606-2621. doi:10.1007/s10439-021-02829-5
21 KATAKIA Y T， KANDURI S， BHATTACHARYYA R， et al. Angular difference in human coronary artery governs endothelial cell structure and function［J］. Commun Biol， 2022，5（1）：1044. doi:10.1038/s42003-022-04014-3
22 WOO H G， KIM H G， LEE K M， et al. Wall shear stress associated with stroke occurrence and mechanisms in middle cerebral artery atherosclerosis［J］. J Stroke， 2023，25（1）：132-140. doi:10.5853/jos.2022.02754
23 丘伟达，夏爽，徐兰，等. 老年颈动脉狭窄患者脂蛋白（a）与颈动脉斑块内新生血管的关系［J］. 中华老年心脑血管病杂志，2021，23（12）：1304-1308.
24 MIGUEL A， EMBALO B， ALVES D H， et al. Immunohistochemical expression of MMP-9， TIMP-1， and vimentin and its correlation with inflammatory reaction and clinical parameters in oral epithelial dysplasia［J］. Appl Immunohistochem Mol Morphol， 2021，29（5）：382-389. doi:10.1097/pai.0000000000000910
25 李丽，杨帆，张小红. 超声造影评估基质金属蛋白酶-9活化调控对颈动脉斑块内新生血管的影响［J］. 实用医学杂志，2023，39（4）：481-486.
26 张莹，傅贤，曾宪凡，等. 急性缺血性脑血管病患者颈内动脉壁面切应力与复发的相关性［J］. 实用医学杂志，2023，39（6）：738-741.
Options
Outlines

/

〈 〉