[Diagnostic value of carotid atherosclerosis score for ischemic stroke]
1Department of neurology, Aerospace Central Hospital, Beijing 100049, China.
Insights
The carotid atherosclerosis score accurately diagnoses ischemic stroke, outperforming other metrics like intima-media thickness. This score offers a valuable tool for identifying patients at risk of stroke.
Area of Science:
- Vascular Medicine
- Neurology
- Diagnostic Imaging
Background:
- Ischemic stroke diagnosis relies on identifying risk factors.
- Carotid atherosclerosis, a key contributor to stroke, requires accurate assessment.
- Current diagnostic tools may not fully capture the complexity of carotid disease.
Purpose of the Study:
- To evaluate the diagnostic efficacy of a novel carotid atherosclerosis score for ischemic stroke.
- To compare the accuracy of the carotid atherosclerosis score against traditional markers like intima-media thickness and plaque characteristics.
Main Methods:
- 151 ischemic stroke patients and 151 healthy controls underwent carotid duplex ultrasound.
- Evaluated intima-media thickness (IMT), plaque number, size, location, echo, texture, and surface regularity.
- Developed and assessed carotid artery plaque score and carotid atherosclerosis score.
Main Results:
- Carotid atherosclerosis score demonstrated the highest accuracy (AUC 0.805) in diagnosing ischemic stroke.
- Significant differences in IMT and plaque scores were observed between stroke patients and controls.
- Carotid atherosclerosis score, carotid stenosis degree, and IMT were associated with ischemic stroke, unlike plaque count.
Conclusions:
- The carotid atherosclerosis score is a reliable diagnostic tool for ischemic stroke.
- This novel score offers superior accuracy compared to existing methods for stroke risk assessment.
- Clinical implementation of the carotid atherosclerosis score can enhance stroke diagnosis and prevention strategies.
Objective:
To discuss the diagnostic value of carotid atherosclerosis score for ischemic stroke.
Methods:
In the study, 151 patients with ischemic stroke were enrolled, who were diagnosed by cranial CT scan or cranial MRI scan, and examined with carotid duplex ultrasound, and 151 healthy check-up cases matched by age and sex were chosen as control group, who were excluded ischemic stroke by cranial CT scan or cranial MRI scan. All the control cases were examined with carotid duplex ultrasound also. Intima-media thickness (IMT), the number of carotid plaques, the size of each plaque, the location of the plaque and each plaque's echo, texture, surface regularity were estimated by carotid duplex ultrasound.
Results:
The IMT of the case group and the control group were (0.946±0.185) mm and (0.863±0.148) mm, and there were significant differences (P<0.001); The parameters of arterial plaque correlated with ischemic stroke were plaque's echo, texture and surface regularity, however the plaque size and location were not correlated with ischemic stroke. The median and quartile of carotid artery plaque score were 3 and 2 respectively in case group, 1 and 2 respectively in control group, and there were significant differences (P<0.001); The parameters of carotid arterial atherosclerosis associated with ischemic stroke were carotid artery plaque score,carotid stenosis degree and IMT, but not the number of carotid plaques. The median and quartile of carotid arterial atherosclerosis score were 5 and 4 respectively in case group, 2 and 4 respectively in control group, and there were significant differences (P<0.001); The area under the curve (AUC) for IMT, the number of carotid plaques, carotid artery plaque score and carotid arterial atherosclerosis score were 0.679, 0.677, 0.704 and 0.805,respectively (P<0.001). The accuracy of carotid atherosclerosis score was the highest.
Conclusion:
Carotid artery plaque score and carotid atherosclerosis score can be used for the diagnosis of ischemic stroke, and the accuracy of carotid atherosclerosis score is higher.
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