Carotid intraplaque neovascularization and cerebral microbleeds: correlation assessed by plane-wave ultrasensitive...

Carotid intraplaque neovascularization (IPN) is a marker of plaque vulnerability, whereas cerebral microbleeds (CMBs) are established markers of cerebral small vessel disease. However, the relationship between carotid IPN and CMB burden has not been well characterized. This study aimed to investigate the association between carotid IPN and the presence and burden of CMBs.

This study was conducted at the Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China. Consecutive patients with carotid plaques identified by carotid ultrasonography were enrolled. Participants were categorized into two groups: the non-cerebral microbleeds (non-CMBs) group and the cerebral microbleeds (CMBs) group, based on susceptibility-weighted imaging (SWI) findings on brain magnetic resonance imaging (MRI). Carotid intraplaque neovascularization (IPN) was assessed using Angio Plane-Wave Ultrasensitive Flow Imaging (Angio PLUS) and categorized as low (grades 0-1) or high (grade 2). Spearman correlation analysis was used to assess the association between IPN grade and CMB burden. Logistic regression analyses were performed to identify factors independently associated with overall, lobar, and deep/infratentorial CMBs.

A total of 493 patients were included, among whom 175 (35.5%) had CMBs. Spearman's correlation analysis revealed a positive correlation between IPN grade and CMB severity (rs = 0.351, p < 0.001). Multivariate logistic regression demonstrated that high-grade IPN was an independent risk factor for the presence of CMBs (OR = 2.793; 95% CI: 1.841-4.239; p < 0.001). Subgroup analysis revealed that high-grade IPN was associated with deep/infratentorial CMBs but not lobar CMBs.

Carotid IPN demonstrates a positive correlation with the severity of CMBs. Furthermore, high-grade IPN is independently associated with the presence of overall CMBs as well as deep/infratentorial CMBs, although it does not exhibit a similar association with lobar CMBs.