PDF(Pubmed)
Abstract：
UNASSIGNED: Intraplaque neovascularization, assessed using contrast-enhanced ultrasound (CEUS), is associated with ischemic stroke. It remains unclear whether detection of intraplaque neovascularization combined with color Doppler ultrasound (CDUS) provides additional value compared with CDUS alone in assessing ischemic stroke risk. Therefore, we investigated the clinical value of combined CEUS, CDUS, and clinical features for ischemic stroke risk stratification.
UNASSIGNED: We recruited 360 patients with ≥50% carotid stenosis between January 2019 and September 2022. Patients were examined using CDUS and CEUS. Covariates associated with ischemic stroke were identified using multivariate logistic regression analysis. The discrimination and calibration were verified using the C-statistic and Hosmer-Lemeshow test. The incremental value of intraplaque neovascularization in the assessment of ischemic stroke was analyzed using the Delong test.
UNASSIGNED: We analyzed the data of 162 symptomatic and 159 asymptomatic patients who satisfied the inclusion and exclusion criteria, respectively. Based on multivariate logistic regression analysis, we constructed a nomogram using intraplaque neovascularization, degree of carotid stenosis, plaque hypoechoicity, and smoking status, with a C-statistic of 0.719 (95% confidence interval [CI]: 0.666-0.768) and a Hosmer-Lemeshow test p value of 0.261. The net reclassification index of the nomogram was 0.249 (95% CI: 0.138-0.359), and the integrated discrimination improvement was 0.053 (95% CI: 0.029-0.079). Adding intraplaque neovascularization to the combination of CDUS and clinical features (0.672; 95% CI: 0.617-0.723) increased the C-statistics (p=0.028).
UNASSIGNED: Further assessment of intraplaque neovascularization after CDUS may help more accurately identify patients at risk of ischemic stroke. Combining multiparametric carotid ultrasound and clinical features may help improve the risk stratification of patients with ischemic stroke with ≥50% carotid stenosis.
We studied whether using contrast-enhanced ultrasound (CEUS) to detect intraplaque neovascularization could help better determine the risk of ischemic stroke. We compared the combined use of color Doppler ultrasound (CDUS) and CEUS with CDUS alone in patients with more than 50% carotid narrowing. Our findings showed that combining clinical details, CDUS, and CEUS was more effective (0.719 vs 0.672). This means that CEUS provides extra insight when gauging ischemic stroke risk compared with CDUS alone. This could help in accurately identifying patients at high risk of stroke. However, more extensive studies are needed to fully understand the role of these tests in the evaluation of stroke risk.
UNASSIGNED: We recruited 360 patients with ≥50% carotid stenosis between January 2019 and September 2022. Patients were examined using CDUS and CEUS. Covariates associated with ischemic stroke were identified using multivariate logistic regression analysis. The discrimination and calibration were verified using the C-statistic and Hosmer-Lemeshow test. The incremental value of intraplaque neovascularization in the assessment of ischemic stroke was analyzed using the Delong test.
UNASSIGNED: We analyzed the data of 162 symptomatic and 159 asymptomatic patients who satisfied the inclusion and exclusion criteria, respectively. Based on multivariate logistic regression analysis, we constructed a nomogram using intraplaque neovascularization, degree of carotid stenosis, plaque hypoechoicity, and smoking status, with a C-statistic of 0.719 (95% confidence interval [CI]: 0.666-0.768) and a Hosmer-Lemeshow test p value of 0.261. The net reclassification index of the nomogram was 0.249 (95% CI: 0.138-0.359), and the integrated discrimination improvement was 0.053 (95% CI: 0.029-0.079). Adding intraplaque neovascularization to the combination of CDUS and clinical features (0.672; 95% CI: 0.617-0.723) increased the C-statistics (p=0.028).
UNASSIGNED: Further assessment of intraplaque neovascularization after CDUS may help more accurately identify patients at risk of ischemic stroke. Combining multiparametric carotid ultrasound and clinical features may help improve the risk stratification of patients with ischemic stroke with ≥50% carotid stenosis.
We studied whether using contrast-enhanced ultrasound (CEUS) to detect intraplaque neovascularization could help better determine the risk of ischemic stroke. We compared the combined use of color Doppler ultrasound (CDUS) and CEUS with CDUS alone in patients with more than 50% carotid narrowing. Our findings showed that combining clinical details, CDUS, and CEUS was more effective (0.719 vs 0.672). This means that CEUS provides extra insight when gauging ischemic stroke risk compared with CDUS alone. This could help in accurately identifying patients at high risk of stroke. However, more extensive studies are needed to fully understand the role of these tests in the evaluation of stroke risk.
摘要：
■斑块内新生血管，使用超声造影（CEUS）评估，与缺血性中风有关。目前尚不清楚斑块内新血管形成的检测与彩色多普勒超声（CDUS）在评估缺血性卒中风险方面是否比单独的CDUS具有额外价值。因此,我们调查了联合CEUS的临床价值，CDUS,缺血性卒中危险分层的临床特征。
■我们在2019年1月至2022年9月期间招募了360例颈动脉狭窄≥50%的患者。使用CDUS和CEUS检查患者。使用多变量逻辑回归分析确定与缺血性卒中相关的协变量。使用C统计量和Hosmer-Lemeshow检验验证了辨别和校准。使用Delong检验分析斑块内新生血管在评估缺血性卒中中的增量值。
■我们分析了162名符合纳入和排除标准的有症状和159名无症状患者的数据，分别。基于多元逻辑回归分析，我们用斑块内新生血管构建了一个列线图，颈动脉狭窄程度,斑块低回声，和吸烟状况，C统计量为0.719（95%置信区间[CI]：0.666-0.768），Hosmer-Lemeshow检验p值为0.261。列线图的净重新分类指数为0.249（95％CI：0.138-0.359），综合歧视改善为0.053（95％CI：0.029-0.079）。将斑块内新生血管添加到CDUS和临床特征的组合中（0.672;95％CI：0.617-0.723）增加了C统计量（p=0.028）。
■进一步评估CDUS后斑块内新生血管形成可能有助于更准确地识别有缺血性卒中风险的患者。结合多参数颈动脉超声和临床特征可能有助于改善颈动脉狭窄≥50%的缺血性卒中患者的风险分层。
我们研究了使用对比增强超声（CEUS）检测斑块内新生血管是否有助于更好地确定缺血性卒中的风险。我们比较了彩色多普勒超声（CDUS）和CEUS与单独CDUS在颈动脉狭窄超过50％的患者中的联合使用。我们的研究结果表明，结合临床细节，CDUS,CEUS更有效（0.719vs0.672）。这意味着与单独的CDUS相比，CEUS在衡量缺血性卒中风险时提供了额外的洞察力。这可以帮助准确识别中风高危患者。然而,需要更广泛的研究来充分了解这些测试在卒中风险评估中的作用.
■我们在2019年1月至2022年9月期间招募了360例颈动脉狭窄≥50%的患者。使用CDUS和CEUS检查患者。使用多变量逻辑回归分析确定与缺血性卒中相关的协变量。使用C统计量和Hosmer-Lemeshow检验验证了辨别和校准。使用Delong检验分析斑块内新生血管在评估缺血性卒中中的增量值。
■我们分析了162名符合纳入和排除标准的有症状和159名无症状患者的数据，分别。基于多元逻辑回归分析，我们用斑块内新生血管构建了一个列线图，颈动脉狭窄程度,斑块低回声，和吸烟状况，C统计量为0.719（95%置信区间[CI]：0.666-0.768），Hosmer-Lemeshow检验p值为0.261。列线图的净重新分类指数为0.249（95％CI：0.138-0.359），综合歧视改善为0.053（95％CI：0.029-0.079）。将斑块内新生血管添加到CDUS和临床特征的组合中（0.672;95％CI：0.617-0.723）增加了C统计量（p=0.028）。
■进一步评估CDUS后斑块内新生血管形成可能有助于更准确地识别有缺血性卒中风险的患者。结合多参数颈动脉超声和临床特征可能有助于改善颈动脉狭窄≥50%的缺血性卒中患者的风险分层。
我们研究了使用对比增强超声（CEUS）检测斑块内新生血管是否有助于更好地确定缺血性卒中的风险。我们比较了彩色多普勒超声（CDUS）和CEUS与单独CDUS在颈动脉狭窄超过50％的患者中的联合使用。我们的研究结果表明，结合临床细节，CDUS,CEUS更有效（0.719vs0.672）。这意味着与单独的CDUS相比，CEUS在衡量缺血性卒中风险时提供了额外的洞察力。这可以帮助准确识别中风高危患者。然而,需要更广泛的研究来充分了解这些测试在卒中风险评估中的作用.
