Predictive value of contrast-enhanced ultrasonography combined with shear wave elastography for risk of ischemic stroke in patients with asymptomatic carotid plaques
Objective To investigate the predictive value of contrast-enhanced ultrasonography(CEUS),combined with shear wave elastography(SWE)for risk of ischemic stroke in patients with asymptomatic carotid plaques.Methods Clinical and imaging data of 90 patients with carotid plaques who underwent CEUS and SWE examinations were retrospectively analyzed.Patients were followed up for 180 d.Ischemic stroke occurred in 8 cases(stroke group),did not occur in 82 cases(non-stroke group).Univariate and multivariate Cox regression were used to analyze the predictors of ischemic stroke events,and a nomogram was developed based on above risk factors to predict the incidence of stroke.Cumulative incidence was evaluated using the Kaplan-Meier survival analysis.Receiver operating characteristic(ROC)curve was generated to analyze the value of each index in assessing the risk of ischemic stroke.Results The risk of ischemic stroke in patients with grade 2 intraplaque neovascularization(IPN)and lower shear wave velocity(SWV)was higher than those with grade 0-1 IPN and higher SWV(P＜0.001,P=0.025).Multivariate Cox regression showed that IPN and SWV were independent risk factors for predicting ischemic stroke in carotid plaque patients(P=0.045,P=0.028).The nomogram developed based on IPN and SWV had good discrimination effect(C-index=0.898).ROC curve showed that the AUC of the nomogram for predicting risk of ischemia strok was 0.897.According to the cutoff value,patients were divided into low-risk group and high-risk group,the risk of ischemic stroke in high-risk group was higher than that in low-risk group(P＜0.001).Conclusion The combination of IPN and SWV demonstrates good predictive value for the risk of ischemic stroke in asymptomatic patients with carotid plaques.
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