Value of multimodal ultrasonography combined with clinical indicators in predicting the progression of ischemic stroke
Objective To analyze the value of multimodal ultrasound imaging based on color Doppler ultrasound(CDUS),contrast-enhanced ultrasound(CEUS)and shear wave elastography(SWE)combined with clinical indicator measurement of high-sensitivity C-reactive protein/albumin ratio(hs-CRP/ALB)in predicting progressive ischemic stroke(PIS).Methods A total of 100 patients with acute stroke admitted to our hospital from August 2019 to May 2023 were selected.All patients received multimodal ultrasound examinations of CDUS,CEUS and SWE on admission,and measurements of blood lipid levels,serum hs-CRP and ALB.Patients were divided into PIS group(NIHSS score increase≥2 points)and non-PIS group(NIHSS score increase<2 points)according to the increase in the National Institutes of Health Stroke Scale(NIHSS)score within 6 hours to 7 days of onset.General data,multimodal ultrasound parameters and hs-CRP/ALB were compared between the two groups.Risk factors for PIS were analyzed by Logistic regression,and then a prediction model was created and validated by plotting the receiver operating characteristic(ROC)curves.Results There were no significant differences in gender,age,body mass index(BMI),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),hypertension,diabetes,coronary heart disease,smoking,plaque length,plaque thickness and plaque echo between PIS and NPIS groups(P>0.05).The proportion of irregular patch surface in PIS group was higher than that of NPIS group(P<0.05).The proportion of P and typeⅡneovascularization in plaques of PIS group was significantly higher than that of NPIS group,and tP and mean transit time(MTT)were lower than that in NPIS group(P<0.05).Max YM,Min YM,Mean YM,hs-CRP and hs-CRP/ALB in PIS group were significantly higher than those of NPIS group,but ALB was significantly lower(P<0.05).Logistic regression analysis showed that irregular patch surface,P,Max YM,Min YM,Mean YM,hs-CRP and hs-CRP/ALB were risk factors for the occurrence of PIS(OR=9.569,1.297,1.082,1.299,1.142,3.797 and 4.231,respectively;P<0.05),while tP,MTT and ALB were protective factors(OR=0.733,0.871 and 0.667,respectively;P<0.05).Being introduced into the regression equation,a prediction model was obtained as follows:Logit(P)=-6.169+9.569×1+1.297×3+0.733×4+0.871×5+1.082×6+1.299×7+1.142×8+3.797×9+0.667×10+4.231×11.The ROC curve showed that the area under the curve(AUC)of the prediction model in discriminating PIS was 0.988(95%CI 0.972-1.000).Conclusion Multimodal ultrasound imaging based on CDUS,CEUS and SWE combined with serum hs-CRP,ALB and hs-CRP/ALB can effectively predict the occurrence of PIS,and favors screening of high-risk groups of PIS.
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