A Study on the Value of Ultrasound Imaging Features in Predicting Intraplaque Hemorrhage in Carotid Arteries
Insights
Ultrasound features like plaque ulceration (PU), juxtaluminal black area (JBA), and normalized wall index (NWI) predict intraplaque hemorrhage (IPH) in carotid plaques. Combining these enhances accuracy for stroke risk assessment.
Area of Science:
- Vascular Ultrasound
- Cardiovascular Imaging
- Atherosclerosis Research
Background:
- Carotid atherosclerotic plaques pose a risk for stroke.
- Intraplaque hemorrhage (IPH) is a key marker of plaque instability and increased stroke risk.
- Accurate detection of IPH is crucial for risk stratification.
Purpose of the Study:
- To evaluate the predictive value of ultrasound imaging features for intraplaque hemorrhage (IPH).
- To compare ultrasound findings with high-resolution magnetic resonance vessel wall imaging (HRMR-VWI) as the gold standard.
- To assess the diagnostic performance of individual and combined ultrasound features for IPH detection.
Main Methods:
- Prospective study of 56 patients with 70 carotid plaques.
- Utilized conventional ultrasound, contrast-enhanced ultrasound (CEUS), and HRMR-VWI.
- Systematically recorded ultrasound features: plaque echogenicity, plaque ulceration (PU), juxtaluminal black area (JBA), normalized wall index (NWI), and lumen stenosis rate (LSR).
- Employed logistic regression and ROC curve analyses.
Main Results:
- Plaque ulceration (PU), juxtaluminal black area (JBA), and normalized wall index (NWI) were independent predictors of IPH.
- NWI demonstrated the highest individual diagnostic performance (AUC 0.78).
- A combined model of PU, JBA, and NWI significantly improved IPH prediction (AUC 0.86, sensitivity 81.82%, specificity 78.38%).
Conclusions:
- Ultrasound features, particularly PU, JBA, and NWI, are valuable predictors of IPH in carotid plaques.
- Combined analysis of these ultrasound features enhances diagnostic accuracy for IPH.
- Ultrasound offers a cost-effective, noninvasive method for early IPH detection and stroke risk assessment.
Purpose:
This study evaluated the predictive value of ultrasound imaging features for intraplaque hemorrhage (IPH) in carotid atherosclerotic plaques, using high-resolution magnetic resonance vessel wall imaging (HRMR-VWI) as the gold standard.
Materials And Methods:
This prospective study assessed 70 carotid plaques from 56 patients who underwent conventional ultrasound, contrast-enhanced ultrasound (CEUS), and high-resolution magnetic resonance vessel wall imaging (HRMR-VWI). Ultrasound features, including plaque echogenicity (PE), plaque ulceration (PU), juxtaluminal black area (JBA), normalized wall index (NWI), and lumen stenosis rate (LSR), among others, were systematically recorded. Logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to evaluate the diagnostic and predictive value of these features for IPH.
Results:
PU, JBA, and NWI were identified as independent risk factors for intraplaque hemorrhage (IPH), with odds ratios (ORs) of 7.43 (95% CI: 2.15-25.67, p = 0.002), 4.90 (95% CI: 1.42-16.92, p = 0.012), and 2.55 (95% CI: 1.19-5.45, p = 0.016), respectively. Among individual predictors, NWI showed the highest diagnostic performance, with an area under the curve (AUC) of 0.78 (95% CI: 0.67-0.89). A combined diagnostic model incorporating PU, JBA, and NWI significantly improved performance, achieving an AUC of 0.86 (95% CI: 0.77-0.95), a sensitivity of 81.82%, and a specificity of 78.38%.
Conclusion:
Ultrasound imaging features, particularly PU, JBA, and NWI, are valuable predictors of IPH in carotid atherosclerotic plaques. Combined analysis of these features significantly enhances diagnostic accuracy. These findings underscore the potential of ultrasound as a cost-effective, noninvasive modality for early IPH detection and stroke risk assessment.
